Protecting access to prescriptions is critical to patient “comebacks”
Like many Texans, I have a great passion for the game of football. I’m not only a fan, but also a former professional player: I was the placekicker for the San Diego Chargers for 10 seasons during the Dan Fouts and Don Coryell years, retiring in 1986 as the team’s all-time leading scorer. While I loved my time playing during those special years, I know that I was extremely fortunate to even be alive and get to experience what it was like to kick a game-winning field goal in overtime of a playoff game.
Thirty-eight years ago, as my third season with the Chargers began, my struggles with ulcerative colitis came to a head. I needed two emergency life saving surgeries six days apart that required over 80 units of blood and left me wearing an ostomy bag. I was devastated, as you can imagine, and was sure my playing days were over. I really wondered what kind of life I could live.
Fortunately, with the Lord’s help, innovative new products and treatments, outstanding medical care and the drive to continue playing, I was given the chance to return to the NFL, where I played for seven more seasons, earned Comeback Player of the Year honors in 1980 and was eventually inducted into the San Diego Chargers Hall of Fame.
But my challenges didn’t end with the end of my career. Shortly after the birth of our last child, I was diagnosed with hepatitis C from tainted blood I had received way back in 1979. Fortunately, over the last few years, incredible breakthrough treatments have been developed that now give patients more than a 90 percent chance of curing the virus. I was one of the lucky ones and am now clear of the virus and in great health.
Today, at the age of 62, I am more appreciative than ever of the medical device and pharmaceutical industries and the many scientists and researchers who dedicate their lives to finding better treatments and cures for patients like me. I believe we are on the cusp of a whole new era in medicine, as the study of genomics and personalized medicine is applied to all kinds of diseases to develop revolutionary, life-saving and life-extending drugs that will allow many more patients make their own comebacks.
With strong bipartisan support, Texas legislators have passed laws over the last 13 years to protect the most vulnerable Texans by ensuring they have the same access I had to the medicines and treatments their doctors determine are best for their care and well-being. These patient protections are critical for those whose health is dependent on specific medicines or targeted combinations of therapies — and whose well-being could be seriously threatened by changes of prescription or delays in receiving drugs.
That’s why it’s so alarming that some lawmakers in Texas are advocating policies that would restrict patient access to the important medicines they desperately need. Such measures would allow insurance companies, rather than doctors, to determine the best course of treatment and medications for patients on Medicaid. If passed, insurance companies would have the option to provide patients with less expensive medicines that may be less effective or even entirely ineffective. Ultimately, insurance companies would be allowed to require patients to “fail” first using lower-cost drugs or treatments before allowing them access to medicines that have proven to be successful and initially prescribed by their doctor.
Healthcare professionals and patients should not have to jump through burdensome administrative hoops to secure the most appropriate therapeutic options. Ultimately, doctors, not insurance companies, should make the determination of the best course of treatment and medications for a patient.
While supporters of these measures claim this restriction in access would save the state money, Texas could run the risk of losing hundreds of millions of dollars in rebates from manufacturers, a method of Medicaid reimbursement in which manufacturers pay more than $1.8 billion back into the program, which has kept prescription costs lower than other states.
My career with the Chargers and my life afterward would not have been possible without the access to the most innovative and effective treatments. I cannot imagine, in the midst of my worst and most urgent struggles, being denied access to the medicines my doctors believed would provide the greatest opportunity for me to get better. Whether ulcerative colitis, Crohn’s disease, hepatitis C or any other illness, patients deserve access to the drugs that will give them the best chance to make their own personal comebacks.