Monday, October 19, 2009

Associated Press Story on Cancer Drug Donation Law

Law to Allow Donation of Unused Cancer Drugs
The Associated Press • October 18, 2009

HELENA (AP) — Wendy Gwinner’s work brings her in contact with people still reeling from a cancer diagnosis. The oncology social worker said she’s seen nearly 100 patients since April who couldn’t afford the drugs needed to treat their disease.

Gwinner hopes a new law that establishes a way for unused, unopened cancer drugs to be donated to participating pharmacies and dispensed to qualifying patients will change that.

The state Board of Pharmacy began developing rules to implement the law at a meeting earlier this month.

“It would be my hope that they feel the urgency in this,” said Gwinner, who works at Bozeman Deaconess Cancer Center.

Since April, the clinic has seen 97 patients “that we had to get assistance so that they could afford the medications that would save their lives,” Gwinner said. Cancer drugs are some of the most expensive ones on the market, said the bill’s sponsor, Rep. J.P. Pomnichowski of Bozeman.

Gwinner also works with Medicaid patients whose cancer diagnosis “sends them into the doughnut hole” — a gap in coverage between Medicaid’s initial coverage limit and the point at which its catastrophic coverage kicks in — during which patients must cover all their medical costs.

“Then the decision becomes, ‘Do I spend every last penny that I saved for my retirement to treat my cancer or do I not treat my cancer?”‘ Gwinner said. “I never want to hear that.”

So Gwinner works with pharmaceutical companies and foundations to seek money to help people get the drugs they need.

On the other side of the issue are people who have been prescribed three months of a drug, such as an anti-nausea medication, but it quits helping after six weeks. Someone else could benefit from the drug, but it’s illegal to give it to anyone else.

“Patients who develop a resistance, patients who pass away, there are drugs and there are patients who need them,” Pomnichowski said. “This is really an attempt to make drugs available that otherwise would be tossed. Perfectly good medication is being thrown away when people who need it can’t have it.”

The cancer drug repository would be the middleman, allowing pharmacies or other health care facilities to accept, store and dispense or administer donated drugs and supplies.

The draft Board of Pharmacy rules limit which drugs can be donated, requires that they be in tamper-evident packaging, that records be kept and stipulates that the drugs cannot be resold.

“This is a very controlled process,” Pomnichowski said. “This is not someone handing off their medication to another patient. Knowledgeable people are handling the drugs.”

Christopher Harris, an attorney representing GlaxoSmithKline, testified during a state House committee hearing that the company “enthusiastically supports this.

“This is an extremely well drafted piece of legislation and has all the safeguards to protect against abuse,” Harris said during the mid-February hearing.

Ron Klein, executive director of the Board of Pharmacy, said he expects a public hearing will be held later this year to discuss the proposed rules and that when the board meets in January, it will review public comment received at the hearing and in writing.

He said the rules could be ready to implement as soon as the latter part of January.

It’s unclear how many people would participate.

“I think it will serve some market, but how big it will be I don’t know,” said Bill Burton, a Helena pharmacist and president of the Board of Pharmacy. “I just know there’s an awful lot of big-dollar items wasted in nursing homes when people die. I think it will serve the public well.”

Montana is one of about 40 states that have or are developing a cancer drug repository.

Nebraska has 77 participants in its program, said Marla Augustine, spokeswoman for the state’s Department of Health and Human Services. But she said the agency doesn’t “have a way of knowing how much it’s used.”

“Our impression is that it’s not used a great deal, but again, we don’t have a good way of monitoring that,” Augustine said.

Gwinner said the key is for people to know the cancer repository exists.

“A huge component of this will be in the implementation,” she said. “Everybody has to know about it. It won’t work unless we have the donations and patients know to ask for help.”

Me and My Avatars

Monday, October 05, 2009

Cancer Drug Donation Program is Neighbor Helping Neighbor

I wrote an op-ed for Montana newspapers about a bill I carried in the 2009 Legislative Session. It was HB409, to allow unused, unopened cancer drugs to be donated to patients who cannot afford them.

The first Montana paper to print the piece was the Fairfield Sun Times!

New Law May Help Cut Costs Of Cancer Treating Drugs

Here's the news on the new law:

Nearly everyone's lives have been touched by cancer. A new state law effective October 1 establishes a cancer drug donation program to help cancer patients get drugs they cannot afford by distributing thousands of dollars of unused medication to patients instead of destroying the drugs.

In the last state legislative session, House Bill 409 created a way for unused, unopened cancer drugs to be donated to participating pharmacies and care facilities and re-dispensed to qualifying patients, who otherwise could not attain them because of their astronomical cost.

The need for this new program is immense. Cancer drugs are among the most expensive pharmaceuticals on the market. They do wondrous things: they target and kill cancer cells, target the interactions between cancer cells and the patient, and help with nausea from chemotherapy. Cancer drugs can also prompt the development of red blood cells and help with a patient’s energy level.

But a drug is only good if it can be administered.

In testimony at the legislature last February, Dr. Jack Hensold of the Bozeman Cancer Center said that, “new cancer therapies are, without exception, very expensive, ranging from $3000 to $9000 in monthly costs. Since nearly all the oral chemotherapies are subject to co-pays, all patients, independent of their insurance coverage, are placed at significant financial risk when diagnosed with cancer. Within the first month of treatment, a patient will be liable for a $5000 payment for their drug.”

The cancer drug donation program will make available very sophisticated drugs from people who want to donate them to people who need them but simply cannot afford them.

Cancer patients testified in support of the bill too. One woman said she was grateful that the hearing was this year and not the previous session because she was undergoing chemotherapy then and was bald. She appeared before the House committee with a packet of medication she wishes to donate, an anti-nausea drug to which she developed a resistance.

She has a month’s supply with an expiration date of 2011. She said, “It’s hundreds and hundreds of dollars in my medicine cabinet. I can’t bring myself to flush it down the toilet. Someone should use these!”

In the Senate, a woman testified that she’d been an office administrator for an oncologist for 20 years and saw the need first-hand. Four years ago, her husband, a former firefighter, was diagnosed with multiple myeloma and undergoes treatment monthly. One of his prescribed medications, Velcade, costs $7000 a month for 21 pills. Another of his drugs costs a co-pay of $4295 a month, and yet another, more than $6000 a month.

It’s difficult enough to face a diagnosis of cancer. Patients who want to fight cancer but who may not have the financial or pharmaceutical means now have a chance to receive drugs from the new donation program. The Montana Board of Pharmacy will adopt rules very soon to implement the law.

In Montana, the spirit of helping one another is strong. There’s no reason for effective cancer drugs to be wasted or destroyed for want of a process to make them available to people in need. That’s why I sponsored House Bill 409. For those with cancer drugs to donate, and for the patients who desperately need the drugs, the cancer drug donation program bridges the gap.

Representative JP Pomnichowski is serving her second term in the Montans House of Representatives. A fifth-generation Montanan, she has worked as an EMT/firefighter, an orthopedic surgery practice manager, and in medical records.

First Winter Storm of Autumn

Sunday, October 04, 2009

Art for All, Everywhere

Friday, I visited the one-room Pass Creek School, 22 miles north of Bozeman, at the invitation of Allison McGree, the teaching artist of the Art Mobile of Montana.

The Art Mobile of Montana mission is "to provide a permanent statewide traveling art
outreach program for schools, the general public, and diverse groups; offer presentations of quality, original art exhibits, teach art lessons, extend teacher education, and emphasize the importance of art and relate to art in a personal way."

I'm an artist, and an art lover. I appreciate the expertise and expression of artists, in all media. And best of all, the Art Mobile of Montana brings art to students statewide, fostering new artists and inspiring art from them. And in tough times, schools make sure they're providing the keys of education, so many do not have art programs now.

Art Mobile of Montana, based now in Bozeman, "provides a traveling art outreach program for those with less access to the visual arts. Targeting students and underserved areas such as Indian reservations, Art Mobile provides not only collections of original works of art but also quality art lessons and teacher workshops in art education."

Allison McGree, the artist/teacher, sets up the traveling display. The artists featured in Art Mobile are primarily Montanan artists. These artists, whose works speak to the rich, visual legacy of the West, are well received by the mostly rural audiences that Art Mobile visits.

When the paintings, drawings, ceramic, leather, and woven art was arranged, Allison asked students to select works of art that interested or appealed to them. Then she described the artist, subject, media, and technique, and compared works of art that express the same subject (mountain landscapes, for instance) but use very different styles (abstract versus literal). Students learned key elements of art: the difference between abstract and 'concrete' art, the diversity of media (it's not just pencils and paper), and two- and three-dimensional art (length and width, depth). It was great to see the students work out the distinguishing elements of the pieces.

Students then participate, making art, in a range of media from printmaking to watercolor to pastels. The art exercise is often related to art works in the exhibits. On Friday, some ledger art from Native Americans was presented, and the art-making was on ledger art.

Ledger art are pictures drawn and painted on ledger pages by Native Americans. Their narrative in ledger art includes pictures of Indians crossing the prairie on horses, battles with other tribes or US soldiers, Native American kids going to reservation schools; the LedgerBook of Thomas Blue Eagle was a featured text on Friday, and it is stunning.

I was so pleased to see the Art Mobile of Montana and Allison McGree in action. The students and teacher of Pass Creek School were wholly engaged in the visit; it was inspiring to see the excitement and enthusiasm of the kids in their desire to create.

More on the Art Mobile of Montana:

In 2007, Sally Williamson, the then-artist/teacher of the Art Mobile, traveled 13,000 miles across Montana and worked with more than 6,000 kids who would never have the opportunity to see and learn about art. In 2003-2004, Art Mobile traveled to 70 sites in 27 counties, reaching 7,256 individuals, mostly students. In FY 2004, Art Mobile received an NEA Challenge America grant of $12,000 for its 2004-2005 activities. During the year, Art Mobile visited 55 sites in Montana (including the state’s seven Indian reservations), reaching just about every area of the state, and serving nearly 7,000 people.

The Art Mobile of Montana receives grants for its annual operating budget. A basic two-hour art mobile visit includes one presentation and one art lesson and costs $165.00. Travel costs are additional, divided among the number of sites presented during one tour.

The Art Mobile is a non-profit organization and is supported in part by a grant from the Montana Arts Council (an agency of state government) and by the National Endowment for the Arts, which believes that a great nation deserves great art. Funding is also received from Montana's Cultural Trust.