"It is a bitter thing to have sitting around staring at me," he said.
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Even in his sadness, he saw hope in that unopened box with 21 tablets of a drug. He wanted to see if it could be donated to another person, "perhaps provided as a sample for a patient less financially fortunate than Maggie and I."
Cancer drugs are among the most expensive for patients. For the Casaccias, the monthly co-pay was over $1,700. Without insurance, Casaccia believes the list price is around $24,000. He is not seeking a refund.
Casaccia pursued his mission of humanity, contacting the doctor's office and the drug maker Pfizer. Over and over, he was told it had to be discarded. In an especially frustrating call to Pfizer, once he reached a human being on its automated telephone system, "I reiterated that I wanted to see it used, not thrown away."
The person apologized, saying "all we can say is..." Casaccia said it seemed to him she was reading from a script.
"I certainly think that the situation is inhumane," Casaccia said. "The medication is from what I've read highly, highly effective in prolonging the life of women with late stage breast cancer."
His dilemma is familiar to that of State Sen. Susan Rubio (D-Baldwin Park), whose grandfather died of cancer. The San Gabriel Valley lawmaker has authored Senate Bill 310 that would launch a pilot program to allow unused cancer drugs to be recycled. As with many proposed bills, it has been amended to gain support. It also addresses liability issues.
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"We've narrowed it down to only 50 participating physicians and doctors," said Rubio. "So hopefully once we see the data, we see that it works, there won't be a problem just expanding it to go statewide."
SB 310 passed by unanimous vote in the State Senate Tuesday and goes now to the Assembly.
Cancer patients pay thousands of dollars out-of-pocket for drugs, even with insurance coverage. "The co-pay can be high," said Autumn Ogden-Smith, legislative director of the American Cancer Society's Cancer Action Network California. "It can delay their starting of their treatment while they pull together their money, and so there is a need there."
The pilot program will be too late to provide Ed Casaccia's box of Ibrance to someone in need. If approved, however, the program would give a lifeline to others in the future.
"If we can save one life, that's great," said State Sen. Rubio. "But I really want to save thousands of lives. So hopefully we can all do it together."
She urged people to contact their assembly lawmakers to support SB 310.