Minnesota State Wire

Legislation Would Ensure Oral Cancer Drugs are Covered the Same Way as Traditional IV Chemotherapy 

WASHINGTON, D.C. – On June 15, 2023, U.S. Senators Tina Smith (D-MN) and Jerry Moran (R-KS) introduced bipartisan legislation to ensure cancer patients who receive oral medications are not hit with thousands of dollars in unaffordable out-of-pocket costs that health plans routinely cover for patients receiving traditional IV chemotherapy treatments.

Their Cancer Drug Parity Act responds to the recent improvements in oral medications for cancer by preventing insurers from charging cancer patients higher copayments for those medications than for chemotherapy medicine delivered intravenously. An estimated 2 million Americans will be are diagnosed with cancer this year.  A study on patients prescribed oral cancer medications found that one in eight patients faced copayments of $2,000 or more for their first prescription.

“Advancements in oral cancer medications have made life better for cancer patients across the country,” said Sen. Smith.  “Oral medications are less intrusive than traditional IV treatments, can be taken at home, and have turned cancer into a manageable chronic disease for many. But while IV treatments are covered by a health plan’s medical benefits – with moderate to minimal copays – oral medications often have high, unaffordable copays.  It can add up to thousands of dollars in costs for patients each year and can cause many to delay or forego necessary care to treat their cancer.  Our bill brings parity to these two kinds of treatments and lowers costs for those taking oral cancer drugs.”

“As the number of orally administered cancer drugs increases each year, patients ought to be able to immediately benefit from these medical advancements,” said Sen. Moran. “This sensible legislation would encourage ERISA health insurance plans to remain on pace with the latest cancer treatments and expand access to orally administered cancer drugs for millions of individuals. Access to new treatments, therapies and cures will help save lives.”

More than 40 states and the District of Columbia have enacted “oral parity” laws, which prevent health plans from creating different cost-sharing requirements for oral and IV cancer medicines.  These laws have made a significant difference for cancer patients—for example, researchers found that the number of multiple myeloma patients initially charge $0 for oral medications nearly quintupled with the enactment of oral parity laws.

Senators Smith and Moran’s bipartisan Cancer Drug Parity Act would build on this state-level success by:

1. Expanding oral parity protections to privately-insured patients whose health care is regulated at the federal level.
2. Preventing insurers from covering oral and self-administered medicines at different cost-sharing rates than IV chemotherapy.
3. Implementing these requirements for health plans that already cover both oral and IV chemotherapy treatments.

The legislation is cosponsored by Senators Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Sheldon Whitehouse (D-RI), Amy Klobuchar (D-MN), Angus King (I-ME), Shelley Moore Capito (R-WV), Cindy Hyde-Smith (R-MS), Jeff Merkley (D-OR), Chris Murphy (D-CT), Lisa Murkowski (R-AK), Roger Wicker (R-MS), and Rick Scott (R-FL).

The bill is endorsed by Accessia Health, AIM at Melanoma, American Cancer Society Cancer Action Network, American Society of Clinical Oncology, American Society of Hematology, American Urological Association, Aplastic Anemia and MDS International Foundation, Association of American Cancer Institutes, Association of Community Cancer Centers, Association of Pediatric Hematology/Oncology Nurses, CancerCare, Cancer and Careers, Cancer Support Community, Colorectal Cancer Alliance, Community Oncology Alliance, Facing Our Risk of Cancer Empowered (FORCE), Fight Colorectal Cancer, GO2 Foundation for Lung Cancer, Hematology/Oncology Pharmacy Association, International Myeloma Foundation, Leukemia & Lymphoma Society, LUNGevity, Lymphoma Research Foundation, Medical College of Wisconsin, METAvivor, National Brain Tumor Society, National Comprehensive Cancer Network, National Patient Advocate Foundation, Oncology Nursing Society, Ovarian Cancer Research Alliance, PAN Foundation, Roswell Park Comprehensive Cancer Center, Susan G. Komen, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Richard J. Solove Institute, WVU Medicine, ZERO Prostate Cancer.

“We are thrilled Senator Smith and Senator Moran have re-introduced this important legislation that will help millions of cancer patients access the care they need by ensuring equitable insurance coverage to treatment,” said Danielle Doheny, Director of Public Policy and Advocacy for the International Myeloma Foundation who chairs the Coalition to Improve Access to Cancer Care. “They made great strides in the Senate last Congress, and we look forward to continuing that momentum. Their commitment to improving access to necessary care and patient affordability is commendable, and we appreciate their tireless work in championing the Cancer Drug Parity Act.”

You can read more about the legislation here.

Original source can be found here.