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CA Bill Would Extend Caps on Drug Costs for PWAs, Others

by Seth Hemmelgarn

State Senator Scott Wiener
State Senator Scott Wiener  (Source:Rick Gerharter)

Gay state Senator Scott Wiener introduced a bill this week that would permanently extend drug-pricing protections for people who are living with HIV/AIDS and other diseases.

The legislation, which hadn't been numbered as of Tuesday, would eliminate the sunset of Assembly Bill 339, the law that caps a person's out-of-pocket costs for a prescription at $250 every 30 days. It would also make permanent formulary standards that keep insurers from routinely placing specialty drugs in their highest pricing tiers.

AB 339's provisions are set to expire at the end of 2019. Gay former Assemblyman Rich Gordon (D-Menlo Park) authored that bill.

"Before AB 339 went into effect, California residents with serious and chronic conditions like cancer, HIV/AIDS, multiple sclerosis, and lupus were particularly vulnerable to higher out-of-pocket costs for their medication," according to Wiener's office. "Specialty prescription drugs were placed on the highest tier in the drug pricing formulary, and consumers often were paying $6,000 in one month alone for badly needed medication."

In a call with the Bay Area Reporter, Wiener (D-San Francisco) said, "Given the federal attacks on health care access, it's even more important now for California to protect health care consumers," and extending the co-pay limits "is critically important."

"Frankly, I would like to see these caps even lower than $250 per prescription per month," he said. That amount "is still high, but it's much, much better than what we were seeing before, which was people having to pay thousands of dollars for a monthly supply of life-saving drugs."

Wiener said he first became aware of the issue when he served on the San Francisco Board of Supervisors, where he represented the Castro and other neighborhoods in District 8.

Constituents living with HIV were telling him of prescriptions refills that were costing them more than $1,000, and people were worried about dying because they couldn't afford the high prices. Wiener held a hearing on the issue in 2015, around the same time Gordon introduced AB 339.

Health Access California is sponsoring Wiener's bill, of which lesbian Senator Toni Atkins (D-San Diego) will be a co-author. The San Francisco AIDS Foundation, APLA Health, and Project Inform are supporting the bill, according to Wiener's office.

Anthony Wright, Health Access California's Executive Director, told the B.A.R., "We want to prevent the extreme cost sharing that leads people to skip medications or otherwise not get medications that they need."

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