The Medical Marijuana Dilemma
High out-of-pocket costs may prove to be an insurmountable obstacle for patients seeking medical marijuana. While the treatment has been legalized, the state has not set a price for it, and insurance companies will not be covering it.
As a result, people like Angel won't have access.
"My story is a long story."
Actually, Angel's not his real name, but we're using it for reasons that will become clear in a minute. Angel's been in Rochester for thirty years, before that, Puerto Rico. In 2006, Angel found out he was HIV positive. But, that isn't the only health problem he struggles with.
"I have chronic back pain, I have arthritis, osteoarthritis, sickle cell, other than my HIV. So, all those together, every disease brings a little bit of pain."
Angel does have access to health insurance, and the standard of care for his kind of pain is opiates. That's what his doctor used to prescribe him.
"Oxycodone, Percosets, like 4-5 different kinds."
These drugs, he says, never really helped, and Angel says he found a different drug. One that helps manage his pain better, and one he's not as afraid of getting addicted to.
"I would say before I smoke it would be about a nine or ten. After I smoke it would be a three or a four. Its very significant, the pain. Because, all my diseases bring pain to me."
Medical Marijuana was legalized in 2014, and it will be available to patients, in theory, January 1. The Compassionate Care Act names HIV and AIDS as qualifying conditions for the drug, but that doesn't mean patients like Angel will have access to it.
For one, Angel says his doctor won't prescribe it to him, and even if he got a prescription, he would still have to pay out of pocket, because medical marijuana is not covered by insurance.
Nick Vita is the CEO of Columbia Care. They're one of five medical marijuana companies opening in New York State. But they also have operations all over the country, including one in Washington DC.
Vita says there, a large portion of their patients are HIV/AIDS patients who used to take opiates for their pain.
"What we've discovered is that about 65-70% of our patients that used to use opiates, no longer use opiates and now use medical marijuana which has a lower side effect profile, you don't have nearly the same addiction issues, and their outcomes are actually better. So if there was a way that we could statistically prove that we could manufacture a consistent product that could be dosed in a particular way that could improve the outcome and the quality of life of a patient, while at the same time saving money because its a naturally grown product, its organic, I think that would be really attractive to an insurance company."
The trouble is, they can't statistically prove that yet. All they have is anecdotal evidence, like Angel's story. Vita says they're going to work with medical partners to compile data on this, but that's looking pretty far ahead.
In the meantime, Angel tells me he has to stop smoking marijuana because he has a job now that tests against it. Even though his job will allow him to take prescribed opiates, marijuana is still off limits.
I asked him, why doesn't he just leave New York? In other states, he wouldn't have to break the law to relieve his chronic pain.
"Even though I wanted to leave Rochester several times, I can't because you can't go nowhere else out of state and get the same care."
The state hasn't yet set regulations on how much medical marijuana will cost the patient, but there are hints. For example, Minnesota has a medical marijuana program a lot like New York: no smoke-ables allowed, and everything is converted into pills, oils or vapors. In Minnesota, medical marijuana costs the typical patient an annual fee, as well as $300-$500 a month.