Meet Pam Holt: Her Cancer Drug Put Her in Deep Financial Hole

Refinancing her house took care of the first year’s out-of-pocket cost for her cancer medicine. But Holt didn’t know how she would afford the next year’s bills. In desperation, she talked with her pharmacist, who told her about a grant she could get to cover her $600-plus copay every month. Through a nonprofit called HealthWell Foundation, Pam’s income qualified her for a grant that pays her monthly copay. One of about seven copay-assistance foundations in the country, HealthWell gets most of its funding from the pharmaceutical and biomedical industry.

“We’re here as a safety net to help patients who have nowhere else to go,” says Shela Halper, HealthWell’s senior director of external relations.

But once again there’s a catch. Holt is about to turn 70. When she does, under federal tax laws she must begin drawing from her retirement savings or pay significant penalties. And then the combination of her teacher pension and Social Security benefits will put her over the income limit for the copay grant.

Taking even a small amount from her retirement account “will jack up my income and I won’t qualify,” Holt says. Her income will increase, but if she has to pay the $640 copay for her cancer drug, she’ll be back in a hole. She doesn’t know what she’ll do in March 2020, when her current grant ends. “I just don’t think I ought to live having to beg for grants when it’s just such a faulty system.”

High drug costs have added to the major life change that Holt faced when she got cancer. “They tell me I can’t live long with this disease, but I can’t even enjoy what time I have because I’m worried about the money,” she says. “I would like to travel, but I can’t. My car is 13 years old. What do you do?”

On March 6, Holt told her story to the Senate Special Committee on Aging, at a hearing examining the high cost of prescription drugs. She urged lawmakers to act, particularly on the CREATES Act, bipartisan legislation that would eliminate some barriers to generic versions of some of the most expensive medications.

“What patients need most is real change to the system and congressional action that will bring down drug prices,” Holt told the Senate panel. “For myself and patients across the country, congressional reform would be life-changing.”