September 15, 2008

State OKs Cancer Drug Repository

By Mary Pickels

When cancer patient Sherrie Neal's prescription was changed just days after $16,000 worth of medication was delivered to her Washington County home, she and husband Michael Neal wondered if the unopened drugs could be made available to other patients.

After talking with Sherri's oncologist, the Neals realized there was nothing they could do with the medication but toss it in the trash or flush it.

That spurred Michael Neal into action. He started by contacting state politicians, then the American Cancer Society, and he ultimately contributed to the passage of a Cancer Drug Repository Program.

The new law allows health care facilities, health clinics, hospitals or physicians' offices to return unused cancer drugs to pharmacies. The donated drugs cannot be resold but will be provided to needy patients. The state Board of Pharmacy will set regulations for dispensing the medication.

The repositories are expected to open in Pennsylvania next year through a network of participating pharmacies and medical clinics.

"I think this is a case where the state government got it right and applied good, old-fashioned common sense," said Sen. Rob Wonderling, R-Montgomery County, who introduced Senate Bill 638, the Cancer Drug Repository Program Act. It was signed into law earlier this year by Gov. Edward Rendell.

"It makes no sense to have these unused drugs being thrown away," Wonderling said. "Why not redistribute them so low-income cancer (patients) can use them?"

A two-year quest

Sherrie Neal, 41, was diagnosed with stage 4 neuroendocrine pancreatic cancer in early 2005. She continues to work as a senior accountant in the Southpointe business park.

"She's very private and quiet about what's going on with her," said Neal, 45, who with his father owns William G. Neal Funeral Homes Ltd.

The couple have health insurance, but out of curiosity Neal asked his pharmacist the costs of various medications prescribed for his wife.

"One medicine we had to get -- for 100 pills -- was almost $3,000," he said.

It was the $16,000 injectable drug that spurred Neal's quest to stop expensive medications from going to waste.

As a funeral home director, Neal said he regularly deals with families who have lost someone to cancer. Sometimes a patient in hospice care can have thousands of dollars worth of unopened, unused medications that have to be destroyed, he said.

"I saw it happen all the time," Neal said.

While talking with a cancer patient on an Internet blog a few years ago, Neal learned that some states -- including Nebraska, Kansas, Colorado and Wisconsin -- had drug repository laws.

"I started calling people," he said. "One thing led to another. I certainly wouldn't take credit for getting this done."

Susan Roberts, the American Cancer Society's state policy manager, said she found there was no mechanism in place to donate Sherrie Neal's unused medication.

"It was illegal to do that in Pennsylvania," Roberts said.

"(Neal) said, 'Look, this is not right. It's a lot of medication. It's expensive,' " she said. "I agreed."

Roberts said she and Neal worked together and with legislators for about two years before the legislation was adopted.

"Mike Neal is absolutely an A-1 champion," Roberts said.

A valuable resource

One of Neal's first political contacts was state Rep. Timothy Solobay, D-Canonsburg.

"He immediately jumped on board," Neal said. The next day, Solobay called and said he'd found Wonderling already had started a similar bill.

Wonderling said he had been contacted by several constituents who suggested drug repositories when Solobay suggested running a mimic bill in the House.

The state Board of Pharmacy will regulate the legislation.

"They've got some great blueprints of other states who've done it," Solobay said.

The intention of the bill was to include anyone who can't afford cancer medication: the uninsured, the underinsured, and the indigent, he said.

State Board of Pharmacy regulations likely will include only medications in original, sealed and tamper-resistant packaging for "recycling."

The American Cancer Society considers unused cancer medication a valuable resource for low-income patients and urged legislators to pass the legislation.

"We support it because cancer medication is so expensive," said Diane Phillips, the society's state agency director for government regulations.

"From an access to care standpoint, it's a great step," Phillips said. "We're anxious to see it getting in operation."

Leslie Amoros, spokeswoman for the Pennsylvania Department of State, said the depository regulations are in "the very preliminary stages."

"We really don't have specifics to share at this point," she said.

Long active with the ACS's Relay for Life, Neal said he and his wife continue to raise money for cancer research as well as for neuroendocrine pancreatic cancer.

They said they are pleased that the legislation passed so quickly.

"We're dealing with a horrible disease," Neal said. "If something good can come out of it, maybe it will give it a little more meaning."

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