Bill establishes depository for donated cancer, HIV medications

Two health-related bills cleared committee Tuesday — one helping redistribute unused prescriptions and another easing eligibility checks on publicly funded children’s health insurance.

Whether receiving treatment for cancer or HIV, patients frequently start and stop medications when trying to find the right prescription for their ailment and end up with leftover doses of an old treatment. Sometimes, people with those medical conditions die, leaving intact bottles of drugs worth thousands of dollars. 

In Indiana, the treatments in both scenarios go to waste because the state has no process for donating those unused medications and redistributing them to those in need. 

“Data and research show that over $3 billion worth of medications are thrown out by hospitals and over $2 million (by) long-term care healthcare facilities,” Rep. Steve Bartels said, just counting cancer treatments.

House Bill 1017 establishing such a program passed the Public Health Committee Tuesday unanimously, with no one testifying against the bill. 

“This bill provides for a voluntary option. Instead of this usable medication that we dispose of, it can be donated and redistributed to what we consider an eligible recipient,” Bartels, the bill’s primary author, said. 

Bartels, R-Eckerty, said 27 other states have such programs, including other Midwestern states. The bill prohibits controlled drugs and doesn’t permit entities to sell the donated prescriptions. It does provide for more experimental cancer treatments to be donated and redistributed – but all donations must be unopened and have no evidence of tampering. 

Providers give their support

Oncologist Yogesh Jethava testified before the committee that he saw patients who had unused drugs to donate while others could no longer afford the copays for their life-saving treatments. To the first patient, Jethava, president of the Indiana Oncology Society, could only direct them to throw away their old medications – even when he knows another patient could use it.

Likewise, those caring for Hoosiers living with HIV said there was a surplus of medication for some people that couldn’t be redistributed to others in need. Alan Witchey, the president and CEO of the Damien Center – the state’s largest HIV service and prevention center and clinic – said his organization worked with 6,500 individuals in 80 counties.

When someone offers to donate unused medication, the organization must decline, even as other clients lose their access to the same drugs when their insurance changes or they can’t afford the copay. Other Hoosiers living with HIV might be homeless and have their medications stolen from them.

“We know there is a need in the community (for someone) to accept donated medications,” Witchey said. “We think it’s a very great opportunity to help us and it gives us another tool to help low-income Hoosiers get the medications that they need.”

The Damien Center has its own pharmacists and medical system that could allow it to accept donations under the bill – which specifies third-party collectors rather than a state-managed entity.

While the Indiana Board of Pharmacy can establish a central depository, they “shall” contract with a third party to implement and administer the program, according to the language of the bill. This service will be paid for with pharmacist licensing renewal fees.

Rep. Ryan Hatfield, D-Evansville, did have concerns that the bill too narrowly defined who was eligible to receive donated drugs by imposing restrictions such as: those who are uninsured or those with an income at or below 200% of the federal poverty level that have a federal health plan that isn’t required to meet minimum essential coverage requirements. 

“I believe that there are very few Hoosiers who fit… However, I understand there is no such change on the table today and I’ll be supporting the overall effort,” Hatfield said. 

Continuous insurance coverage for children

The committee also unanimously approved legislation that reduces the number of eligibility redeterminations for minors using the Children’s Health Insurance Program (CHIP).

Currently, CHIP and Medicaid operate under the same continuous enrollment requirements, in which their coverage can abruptly end following a circumstantial or administrative change in coverage.

But the federal omnibus bill passed last month requires states to transition coverage for children to only annual checks.  Roughly half of states, including Indiana, will need to change their policies. 

Allison Taylor, the state director of Medicaid, said the Family and Social Services Administration was already considering the change prior to the federal directive and estimated the change would impact 11,000 children at risk for losing coverage annually. 

“The reasons for children losing coverage, oftentimes it’s seasonal employment and so (this is) really trying to get rid of that volatility for the child who is impacted by fluctuations in income or maybe a lack of compliance with some of the paperwork requirements,” Taylor said. 

Taylor clarified that “triggering events” to redetermine coverage for adults will be unaffected. 

Bill author Rep. Ann Vermilion, R-Marion, said that the state already did this for children under the age of three. 

Both bills head to the House floor for discussion before the full chamber.