GMHC Applauds Passage of Anti-Mandatory Mail Order Pharmacy Bill in the Assembly That Addresses Medication Crisis…

NEW YORK, June 10 -- Gay Men's Health Crisis issued the following news release:

Today, countless New Yorkers facing life-threatening and chronic conditions, including cancer, hepatitis, HIV, multiple sclerosis, infertility, rheumatoid arthritis, hemophilia, and many others, moved one step closer to being able to decide for themselves whether to fill their prescriptions by mail or at their local pharmacy. New York's Anti-Mandatory Mail Order Pharmacy Bill closes a loophole in state law that currently allows the health insurance industry to prevent local pharmacies from qualifying to fill prescriptions deemed "specialty" by the industry, even if they match the cost.

As a result, consumers report that their prescriptions are lost in the mail or stolen, requiring them to pay the full cost for replacements. Drug regimens are interrupted, which leads to resistance and more expensive treatment. Prescriptions that require refrigeration are left to spoil at the front door. Confidential health information is disclosed to neighbors who receive medications in error. Drug counseling from a local pharmacist is replaced by an unfamiliar voice on the phone that has no relationship with patients, no incentive to ensure that medications arrive on time, and no accountability if a prescription is lost in the mail or stolen.

"I've missed doses. That would never have happened with my local pharmacy," said a GMHC client who is being forced to use United Healthcare's mail order pharmacy, OptumRx. When OptumRx lost his HIV medication in the mail, a representative said that he would either have to skip his treatment for three weeks or pay over $1,000 for a new prescription. "My local pharmacy would never allow a prescription to run out." He continued. "It's really dangerous to miss HIV medication."

Testimonies from GMHC clients and staff expose the misleading claims made by the health insurance industry that their mail order businesses provide better medication access, customer service, and that individual consumers can receive hardship exemptions.

"GMHC clients constantly worry about getting their medication on time," said Lyndel Urbano, Manager of Government Affairs at GMHC, "and I know about this first-hand. Over the past year, my medications arrived late three times and for two months in a row they were left in my neighbor's mailbox. I asked for a hardship exemption, but they refused. It took fighting for over a year and assistance from Attorney General Schneiderman to finally be able to fill my prescriptions at my local pharmacy."

This May, groups representing over 70 health care consumer organizations from across the state signed a letter calling on the New York State Legislature and Governor Cuomo to pass and sign the bipartisan Anti-Mandatory Mail Order Pharmacy Bill, which is sponsored by Democratic Assembly Member Carl Heastie and Republican Senator George Maziarz.

"GMHC thanks Assembly Member Heastie, Speaker Silver, and the Assembly for taking this important step toward protecting New Yorkers' health, including those who are living with HIV/AIDS," concluded Jason Cianciotto, GMHC's Director of Public Policy. "Now it's time for the Senate to act. In 2012, the State Legislature and Governor ensured that State Medicaid enrollees were not forced to use mail order pharmacies. The law should be the same for all New Yorkers."

A quote sheet from GMHC featuring client testimonials about their experience being forced to use mail order pharmacies is below. Clients are also available by request for live interviews. Excerpts from Consumer Testimonials: Experiences with Mandatory Mail Order Pharmacies

Prescriptions Delayed, Lost in the Mail, or Improperly Filled:

"I've missed doses. That would never have happened with an old pharmacy. My old pharmacy would never allow for a prescription to run out, they would be proactive. This mail order pharmacy is not.... It's really dangerous to miss HIV medication."

"After a few days waiting, I contacted Medico to discuss the whereabouts of my medication. I was told the package was mailed using first-class mail and to wait 3-5 days before making a lost prescription claim. A week later, I called to inform them the package had not arrived and to request immediate replacement as my existing supply was almost depleted."

"Medico did not have sufficient inventory to refill my blood-pressure medication with the 10mg tablet I was prescribed. Instead, Medico sent a double supply of 5mg tablets without any indication they had altered the prescription or special instructions to alter my routine. As a result, I took an inadequate dose for almost a month before noticing that the remaining quantity of pills was too large."

"My insurance switched specialty pharmacies without telling me. I am running out of medication and don't know who to call and if they are going to refill my prescriptions. I have had to go to the doctor multiple times this week to get a shot that normally I give myself and pick up various medications."

"Around the holiday time my meds didn't arrive. OptumRx has no policy or procedure in these situations to replace the order. I called them to work something out so I could maintain compliance with my treatment regimen, but on the phone they were completely unyielding to accepting any burden of responsibility.... I had to wait until the next month's order cycle when I could reorder this medication about three weeks after this incident."

"If I were still with my neighborhood pharmacist, this would not have happened. If for some reason my HIV medication was not found, they would work on getting me new meds. This mail order pharmacy that I was forced to switch to has compromised my health."

"In one instance, the mail order pharmacy delayed filling a prescription for a type of Human Growth Hormone (used, among other things, to combat AIDS wasting and lipodystrophy in people with AIDS) because it required special internal documentation.... It took a couple of months to resolve the issue. A mistake was also made that for no reason simply voided my prescription of the HIV medicine Stribild."

Broken Relationship with Trusted, Local Pharmacist; Dangerous Lack of Prescription Drug Counseling; Higher Costs for Consumers:

"OptumRX Specialty Pharmacy Reps cannot authorize or answer questions related to any medication not considered "specialty". This is a serious concern given I rely on my Pharmacist to verify and cross check interactions that my numerous doctors may have overlooked or not known to question."

"...the mandate to use a mail order pharmacy disrupts the trusting relationship I have with my local retail pharmacists. My local retail pharmacists know all the "specialty," non-"specialty," and over-the-counter drugs I take. I often request confidential advice about how to deal with side effects, for example."

"...Coordinating and scheduling doctor visits can often result in new prescriptions that must be filled before existing refills expire. There have been numerous occasions where I am a week late and cannot obtain a refill until I see the doctor. It is these circumstances that my local pharmacist has come to the rescue."

"The pharmacist always works to minimize my copayment regardless of source; something I doubt is in OptumRX Specialty Pharmacy Division's best interest. More importantly, my local pharmacy has often loaned a "2-3 day" emergency supply (with no advance notice) knowing that the prescription and insurance to cover the loan is coming."

"My pharmacists are aware of my bouts of illness and hospitalizations and they assess my health and well-being based on visible cues. They tailor their conversation to buck me up or to pass on information about programs of drug manufacturers that assist with co-pays of private insurers, empowering me to continue coping with the challenges of having of AIDS."

Concerns about Health Care Information Privacy:

"All I ask is for some control over my own privacy and who knows about my illness and what medications I am taking. I would rather pick up the medications at a pharmacy. That way I would have control over who sees my medications. On several occasions I have not received my medications on time, and twice, including this month, my medications were left in my neighbor's mailbox."

"I work entirely alone, have no family in NYS and have no alternative address to which I could send sensitive confidential materials such as my medical prescriptions. Certainly, no one in my professional circles is aware of my status, and it would be extremely compromising should they become aware of it."

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