Protect prescription drug affordability and access in California

OPINION – In high school I discovered my passion for scientific subjects. I knew I wanted to turn my passion into purpose. I found a career path in a field of health care where science and helping people meet: pharmacy.

I began working as a pharmacy technician during college and quickly found fulfillment helping patients in need, seeing firsthand the value of building one-on-one relationships.

Now, as the Pharmacist in Charge at the CVS Health CarePlus specialty pharmacy in San Francisco’s Castro District, I oversee our patient management program. My hardworking team of four pharmacists and 10 technicians seeks to nurture strong one-on-one relationships with the folks we serve. I’m proud my patients know me by name and know they can lean on our team with questions about their prescriptions, and that we will provide extra support as they navigate their treatment plans.

Pharmacy benefit managers, like CVS Health’s PBM, play a vital role in keeping my patients’ drugs affordable and accessible. However, I am increasingly worried about possible legislation here in California which would limit PBMs’ ability to help manage costs for patients like the ones I serve.

Some provisions contained in SB 966 would effectively eliminate many of the mechanisms and tools used to make lower cost coverage more accessible, causing care disruptions and pushing costs higher for unions, employers, and employees. For instance, this bill could increase health care costs for small businesses and unions by limiting their ability to use high-quality, low-cost pharmacy options in their coverage plans, in turn eroding plan sponsors’ trust that their members are going to pharmacies that meet the highest standards.

Many of the patients we care for have rare and complex conditions – including HIV, cancer and autoimmune diseases – which require specialty therapies. On a given day, we research financial assistance options for patients, offer in person and over the phone consultations, work with doctors to ensure patients are compliant with their medication regimen and ensure continued insurance coverage of specialty medication costs.

Working in the heart of the Castro District means we predominantly serve members of the LGBTQ+ community for our patient walk-in demographic, in addition to servicing patients by mail order throughout California and Nevada. It is incredibly rewarding to serve patients and ease any worries that they may have about their medical care with a patient-centric focus without social stigmas.

I recall one patient – we’ll call them Noah – whose complex medication regimen, including PrEP (a preventative medication to reduce the risk of HIV infection), made adherence particularly difficult for them. What’s more, Noah expressed concerns about the stigma associated with taking PrEP.

To help ease Noah’s anxiety and improve medication adherence, we separated medications by day and the time they need to be taken. We also provided detailed directions for how and when to take each prescription, as well as possible drug-drug interactions.

Additionally, we ensured the shipping label excluded medication brand name, limiting the possibility that someone could infer a medical condition based on drug identification. For patients like Noah with chronic conditions, small touches like these make all the difference. Noah’s appreciation of our team of pharmacists made the extra effort more than worthwhile.

Stories like this shouldn’t be taken for granted. I call on California’s legislators to do the right thing and provide the right policy environment to facilitate a strong patient-pharmacist relationship and ensure patients have access to the prescriptions they need.

Steven Wang is the Pharmacist in Charge at the CVS Health CarePlus specialty pharmacy in San Francisco’s Castro District.