Passage of NJ S-1614 to Make Prescription Drugs More Affordable for New Jerseyans by Jongwon Park, P4 On July 10th, Governor Murphy signed bill S-1614, which extends Medicare’s new $35/month insulin out-of-pocket cap to state-regulated markets and NJ public employee plans, as well as capping out-of-pocket costs for EpiPens and asthma inhalers at $25 and $50 respectively for a month’s supply.1 Photo credit: Dennis Macdonald via Getty Images
Asthma, diabetes, and anaphylaxis are distinct medical conditions with unique characteristics and treatment approaches that affect millions of Americans across all age groups. Inhalers, insulin, and EpiPens are crucial medications for managing and improving the quality of life for individuals with these conditions. For an individual without insurance, paying for these life-saving medications out of pocket may cost several hundred dollars per month, and potentially even higher for those with additional coexisting conditions. Adherence to medications is critical in improving outcomes for people with chronic conditions. In a meta-analysis
of sixty-three studies assessing patient adherence and outcomes of medical treatment, the outcome difference between high and low adherence is 26%, with adherence most strongly related to outcomes in studies where the disease is chronic.2 For potential life-long conditions such as asthma and diabetes, low-cost medications and programs promoting adherence work towards improving outcomes for patients across New Jersey. The passage of bill S-1614 comes at a time when affording chronic medications is becoming more and more challenging for New Jerseyans. According to a survey of more than 1,100 New Jerseyans in October 2022, 44% of
Table 1: Meta-analysis on Patient Adherence and Medical Treatment Outcomes - Results # Of Studies
# Of Subjects
Risk Difference (95% CI)
Odds Ratio (95% CI)
63
19,456
0.26 (0.20 - 0.32)
2.88 (2.23 - 3.73)
uninsured respondents cited “too expensive” as the major reason for not having healthcare coverage, and 23% cut pills in half, skipped doses of medicine, or did not fill a prescription due to high costs.3 Additionally, there is a concern for the future of medication costs in New Jersey, with 54% of participants reporting being “worried” or “very worried” that prescription drugs will become unaffordable. With this new legislation, New Jersey becomes the second state in the United States to create a ceiling for out-ofpocket costs for asthma inhalers and EpiPens, and joins the list of several other states capping the cost of insulin. The now-enacted law creating price caps for asthma inhalers, EpiPens, and insulin will go into effect on January 1st, 2024, allowing New Jerseyans to have improved access to medications to manage their chronic conditions. References 1. Governor Murphy Signs Legislative Package to Make Prescription Drugs More Affordable for New Jerseyans. Official Site of the State of New Jersey. July 10, 2023. Accessed November 5, 2023. https://www.nj.gov/governor/ news/news/562023/approved/20230710a.shtml 2. DiMatteo R, Giordani P, Lepper H, et al. Patient Adherence and Medical Treatment Outcomes - A Meta-Analysis. Medical Care (2022); 40(9):p 794-811. 3. New Jersey Residents Struggle to Afford High Healthcare Costs; Worry about Affording Healthcare in the Future; Support Government Action across Party Lines. Altarum. January 2023. Accessed November 5, 2023. https://healthcarevaluehub.org/application/files/5516/7450/4192/DB_ 140_-_NJ_Affordability_Brief.pdf
The Microbiota and its Effect on Skin by Joanna Kusmierski, P2 Imagine this: it’s the morning of your drug monograph presentation and you look in the mirror to see a few massive, inflamed, and painful red mountains on your face. You think to yourself, “Rats! I made sure to take care of my skin this week!” You used a lot of moisturizing creams, many acne products like benzoyl peroxide, and even the most expensive of facial washes. Even after all that time and money spent on facial products, nothing prevented the new breakout on your face. However, some-
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thing you may not have considered was your very stressful week with multiple pharmacy exams and your unhealthy eating habits, often ordering takeout to save some time. This is an instance in which our gut-skin axis plays a role. Your gut-skin axis is highly dependent on the microbiome inside of your gastrointestinal (GI) tract. When your GI tract is disturbed, it can have a profound impact on your health, including your skin. Some factors that affect the microbiome include the method in
which an infant was delivered, breastfeeding, infections, medication, diet, and even stress.1 When you are stressed, your brain sends signals to your enteric nervous system, the small brain inside your gut, altering the gut microbiota and upsetting your GI tract.2 Additionally, to our surprise, the gut and the skin share many features, such as being covered by epithelial cells. So, how can we maintain a healthy microbiome within our gut and skin? Researchers and dermatologists say Continued on next page
