Right-to-Die Group Comes up With New, Cheaper Medication

Right-to-die advocates in Washington state have created a cheaper alternative mixture of medications to help terminally ill patients legally end their lives after a drug company abruptly hiked the price of a drug commonly used for the purpose.

Doctors with the End of Life Washington advocacy group concocted the alternative for about $500, after Valeant Pharmaceuticals International of Quebec acquired the drug and jacked up the price to about $3,000, The Seattle Times reported (http://goo.gl/JCpgg9).

“We thought we should concoct an alternative that would work as well,” said Dr. Robert Wood, a University of Washington HIV/AIDS researcher who volunteers with the group. “It does work as well.”

Doctors in Oregon have also adopted the drug mixture. Officials in California, where a similar law takes effect later this year, are considering it as well.

Valeant Pharmaceuticals and other drugmakers have come under fire from Congress for buying up old drugs and hiking prices many times over what patients had paid for years. Last year, it acquired the rights to Seconal, the trade name of secobarbital sodium, the most commonly prescribed drug used by terminally ill patients to end their lives under the law.

The firm doubled the cost, from $1,500 to more than $3,000 — and up to $5,000. The sedative has been available for nearly 90 years and once sold for $150 for a lethal 10-gram dose, The Times reported.

“People were horrified,” Beth Glennon, a client-support coordinator with End of Life Washington, told The Times about the price increase. “The cost increase has been significant for some people. Some are on a very fixed income.”

Health insurance often doesn’t pay for such drugs that are not covered under Medicare. Washington’s Medicaid plan does not cover the drugs, and several Catholic health systems that prohibit doctor-aided death based on religious objections also do not cover it.

When Valeant hiked prices, Wood and other doctors turned to a compounding pharmacist for an alternative. The result was a less-expensive mix of three medications — phenobarbital, chloral hydrate and morphine sulfate. The powdered drugs could be mixed with water, alcohol or juice.

The new medication tastes worse, may take longer to work than Seconal, and burns the mouth, Wood said. Even so, about one-third, or 55, of the 155 patients seen by End of Life Washington last year chose the cheaper medication, he said.

Last year, 16 of the 132 people who died in Oregon under the state’s law took the new mixture.

News reports last month suggested that Valeant increased the price as a reaction to California’s law, a contention rejected by company officials.

“The suggestion that Valeant raised the price to take advantage of a law that had not yet passed, for a use for which the drug is not even indicated, defies common sense,” company officials said in a statement.

Washington’s right-to-die law went into effect in 2009 and allows terminally ill patients with less than six months to live to request lethal medications from their doctors.

In 2014, 176 terminally ill patients in Washington received prescriptions to help end their lives and 170 died, according to state health officials. Of those who took medication, about two-thirds used secobarbital.


Information from: The Seattle Times, http://www.seattletimes.com

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