Op-Ed: NJ Residents Deserve Affordable Access to Their Prescriptions

Tina Jacobs | April 17, 2019 | Opinion
Out-of-pocket costs for critical drugs can often swing wildly, leaving patients and their caregivers with few good options

Tina Jacobs
My daughter was 21 when she was diagnosed with depression and anxiety. Like most moms, I wanted to make sure she got the help she needed and the best care available. We did all we could to make sure that happened.

In 2017, her doctor prescribed Latuda, a once-a-day prescription that’s approved to treat bipolar depression in adults. This new medication was working and, originally, our co-pay for this medication was just $25 a month. At the time, my daughter was doing well on the treatment, so we kept her on it.

Then January of 2018 came.

When I went to the pharmacy to refill her prescription, they told me the cost was $500 a month for the same drug. Thinking it was a mistake, I called my insurer and they said there was nothing they could do. I tried everything to get a discounted rate. I called my daughter’s doctor to see if there were any samples we could use until we figured out a long-term solution. I called our insurance company constantly to see if there was another option we hadn’t thought about. Finally, I started cutting my daughter’s pills in half, stretching out the doses so they would last two months instead of just one.

Her doctor had to slowly take her off that medication and find a new one that worked and was affordable. She couldn’t find one, so she was put back on Latuda. This year my co-pay is $390 — still way too much. My daughter is now seeing a new doctor and once again they are trying to wean her off and find something else that works.

This is always difficult for someone who suffers from anxiety and depression. Now we will have to experiment one more time with new medications until we find one that works and we can afford.

No one immune to rising costs

No patient should have to go through this. But insurance companies get away with it all the time by shifting the burden onto patients through high out-of-pocket costs. It seems to defy common sense, because insurance is supposed to be for when we get sick and when we need help. That’s why we pay our premiums.

I now see just how difficult it can be for patients to get access to the medications they deserve. No one is immune to rising out-of-pocket costs.

On March 25, the New Jersey State Assembly unanimously passed legislation that would require insurers to limit patient cost-sharing and provide an appeal process for certain prescription drug coverage. These protections can help not only my family but provide relief for countless New Jersey residents.

Now it’s up to the Senate to do its part and pass S-1865, which has bipartisan support from Senate Majority Leader Loretta Weinberg and Minority Leader Thomas Kean Jr.

My story is difficult for me, but I’m not the only one who has had this experience. Unfortunately, it’s all too common. The good news is you can do something about it.

You have the power to make a difference. Contact your state senators and ask them to support S-1865 so patients can get affordable access to the medications they need.