Posted: | August 29, 2014 10:54 AM |
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From: | Representative Matthew E. Baker |
To: | All House members |
Subject: | Oral Chemo Parity |
In the near future, I will be introducing legislation that will provide for equal access to chemotherapy treatments. Over the years, cancer treatment methods have been changing. Traditional anti-cancer medications were primarily administered intravenously, attacking both cancerous and healthy cells alike. Conversely, orally administered anti-cancer medications have been developed more recently to target only cancer cells, having fewer side effects. Additionally, oral anti-cancer medications have shown to be far more effective for some forms of cancer. Intravenous anti-cancer medications are typically covered under a health plan's medical benefit, often requiring patients to pay a minimal fixed co-payment. Orally-administered anticancer medications, however, are covered under a health plan's pharmacy benefit. Under the pharmacy benefit, oral anti-cancer medications are classified in the highest tier of a health plan’s cost-sharing system, requiring patients to pay a percentage of the total cost of the drug, generally between 25-30%. This creates an enormous financial barrier for patients to access orally administered drugs prescribed by their cancer physician for treatment. Increases in out-of-pocket costs of anti-cancer medications can lead to a decrease in adherence to treatment, further risking patient health and making treatment longer, more expensive and less effective. My legislation will prohibit insurance policies from placing oral anti-cancer medications on a specialty tier or charging a coinsurance payment for the medication, helping more patients afford a more convenient form of cancer treatment. As of August 2014, 34 states have enacted oral chemotherapy access laws. I hope you will join in co-sponsoring this important legislation that will increase access for cancer patients. This legislation is supported by the Leukemia & Lymphoma Society. Thank you for your interest and support. |
Introduced as HB2471