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Comment & Response
August 2017

Insurance Coverage and Aid-in-Dying Medication Costs—Reply

Author Affiliations
  • 1Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 2Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 3Division of Medical Oncology, University of Washington School of Medicine, Seattle
  • 4Department of Pharmacy, Seattle Cancer Care Alliance, Seattle, Washington
JAMA Oncol. 2017;3(8):1138. doi:10.1001/jamaoncol.2017.0406

In Reply We appreciate the thoughtful comments of Grube and Cardenas in response to our recent article.1

We agree with the observation that many commercial insurance plans do cover the cost of secobarbital for use in aid-in-dying. Of the 35 patients at our center participating in the Death With Dignity program who were prescribed secobarbital between 2010 and 2016, 12 patients (34%), all of whom had commercial insurance, received some degree of coverage for this medication. Copayments for these 12 patients ranged from $2.00 to $1236.26. The remaining 23 patients (66%) either chose to pay cash for the medication or were insured through a federally funded plan (including 7 Medicare beneficiaries, 2 federal employees, 1 Tri-Care enrollee, and 1 Community Health Plan of Washington enrollee) that did not cover any portion of the secobarbital cost.