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Issue Background

Medication Adherence

Poor medication adherence (patients taking medications as directed by their healthcare provider) leads to as many as 125,000 deaths, tens of millions of unnecessary hospitalizations and outpatient visits and as much as $290 billion in wasted spending every year.

  • Eight out of ten medical conditions —almost all of them chronic diseases— are treated primarily with prescription medication.
  • Effective treatment with medication improves patient health, reduces the risk of hospitalization or death, and lowers the overall cost of healthcare.
  • However, as many as 75% of patients do not take their medications as prescribed. Patients cite fear of side effects, perceived ineffectiveness of therapy, mistrust of the medical system, inconvenience, and cost.
  • Two leading strategies recommended by patient advocates for improving medication adherence are: (1) Improving patient understanding of their medical conditions and prescribed therapy and (2) Ensuring patient-centric access to prescription medications.

Existing California law does not provide guidance regarding mandatory mail order, refill synchronization, or early refills for eye drops. However, all three of the patient protections in this bill are taken directly from Medicare Part D requirements and guidance intended to protect patients and improve medication adherence.

In response, Assemblymember Susan A. Bonilla introduced medication synchronization legislation (A.B. 2418).  As introduced, A.B. 2418 sought to allow patients to opt out of mandatory mail order programs if they prefer to obtain their prescriptions from a pharmacy or clinic and streamline refill synchronizations to allow patients to pick up all of their prescriptions during one visit to the pharmacy. 

As amended in the Senate, it requires insurers to allow insured patients to refill prescriptions at a prorated amount in order to sync refills of multiple prescriptions. 

A.B. 2418 successfully passed both chambers and will be sent to the Governor for his consideration. CRA issued a Call to Action on August 26, 2014, urging its members to contact the Governor in support.  Unfortunately, the Governor vetoed the bill on September 25, 2014. Read the Governor's veto message.

CRA Correspondence

Read CRA's June 2, 2014 letter to Senate President pro Tempore Darrell Steinberg in support of AB 2418.

Read CRA's Floor Alert to the Senate in support of AB 2418, issued August 19, 2014.