Medical Aid in Dying Patient Chooses His Last Day; Arkansas Medicaid Work Requirements Could Cost Thousands Coverage; CVS Launches Program in Response to Trump Administration Blueprint to Lower Drug Costs

August 20, 2018 by Chris Pirschel Former ONS Staff Writer/Producer, and Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

No One Is Ever Really Ready: Aid-in-Dying Patient Chooses His Last Day

With more states legalizing medical aid in dying options for patients, the process is often vague and misunderstood. One patient, Aaron McQ, shared his story (https://khn.org/news/no-one-is-ever-really-ready-aid-in-dying-patient-chooses-his-last-day/) as he prepared to self-administer his life-ending medication. His story explains the nurse's key role in education and shared decision making to address the concerns of the patient.

Although not legal in all states, medical aid in dying is becoming part of the conversation (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=nXeyHYayZ1jnpUb2h5ZOzCFPZB0xpty98OfzKgiNwJc18ra_lqV0DuTxnapBtZV6-rjdP7mhcUbMpv6XaW3jmg~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~) for many terminally ill patients. Depending on the state and its legislature's political leanings, more places throughout the country are having difficult end-of-life discussions about patient choice. It's an emotional, complicated, and personal topic. Oncology nurses are facing new questions about medical aid in dying, even in states where legislation hasn't passed. Learn more about ONS's statement on the role of the nurse (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=Ht0655Oz_sD5O9s7GNA6JRd4RFEM278sM-wykXccAwQLbMw7D5YP5skeQOn7QVBetvsB1T3cBaRGTu5DSZwbrw~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~) in such situations, the need for advance directives (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=1dTe3xWFpsC5LhjkpcFvntR5tHOMBU_pnlfphc3LCbk5qGu_BgMQTJC9rZQ5k7yY-9Ok2MhNjcUUcbrVEQhe6g~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~), and the importance of effective palliative care for patients with cancer (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=qWfcvyMAtshD0VxE-cVCBf6fKi4Us-QkAMK_2s7UnbCMRA86Wzdw0wHHIcXK0HmZZdxFdRD9XApEx3WJLJMIGw~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~)

Arkansas Medicaid Work Requirements Could Cost Thousands Coverage

Recent reports from Arkansas show that Medicaid enrollees are struggling to meet new work requirements (http://thehill.com/policy/healthcare/401975-new-data-shows-arkansass-medicaid-work-requirements-could-cost-thousands) set out by the state, potentially impacting thousands seeking healthcare coverage. Work requirements come as part of new federal policy allowing states to add employment parameters to Medicaid benefits.

As many opponents feared, it's having a negative impact on access to coverage for beneficiaries in states that enacted the requirements. This is a big reversal from the way things have been done in the past, and it could have political consequences at the ballot box in November. Oddly enough, states that have high Medicaid enrollment numbers and even higher unemployment rates are the ones endorsing the new policy. It will likely lead to a downstream effect on state budgets and federal allowances for healthcare, welfare, and unemployment costs. As one of its central policy tenets, ONS continues to champion access to quality cancer for all (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=YqDYz27Q--OM0H49aw_0cBzBaw3_JSZPmMip9BO4hfuYTMlc5cJjvFCcH2FD6doTCysdndgqVLCRzOKg0U-8Ww~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~).

CVS Launches Program in Response to Trump Administration Blueprint to Lower Drug Costs

The high cost of prescription medications is not a new issue. In June, the Trump administration announced its blueprint to lower drug costs (http://send.ons.org/link.cfm?r=PaiK6-5zhDkSR0zw_2KlyA~~&pe=8tq9xVIBIx1_WKs6Vt1GSBRakk7TC2vW7o75BYPFo4TlZZBir-Fy5xIj7tn-Jjnc3t_81icybdXeb7l3w73otw~~&t=c8gTIi0fbraFoU7Zbz1Zfg~~), charging the Department of Health and Human Services to make medication costs a top priority. Since the announcement, efforts have been made in other ways to find innovative solutions to reduce costs for patients. Recently, CVS Caremark announced (http://thehill.com/policy/healthcare/401814-cvs-program-will-target-expensive-new-drugs) it would allow clients to exclude coverage for medications with high launch prices. This program—a common practice in Europe—is used to encourage manufacturers to lower prices by using methods to compare a drug’s effectiveness against its cost.

Many elements impact high prescription medication costs, including drug company profit margins, and the rise in out-of-pocket fees for life-saving drugs is having a direct impact on patients. Pharmacies have felt the pinch of high costs and are now pushing back. CVS's effort to shift the cost—if not the responsibility—to the manufacturer could result in potential change. Drug companies are likely eager to find a solution before government intervention and oversight occurs.


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