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Higgins, Lance introduce Cancer Drug Coverage Parity Act

by jmaloni


Sat, Jun 13th 2015 08:05 am

Measure ensures cancer patients access to life-saving drug treatment

U.S. Reps. Leonard Lance (New Jersey) and Brian Higgins introduced the Cancer Drug Coverage Parity Act, legislation that would require health insurance plans that cover traditional chemotherapy to provide equally favorable coverage for orally administered anticancer medications.

"Insurance coverage for cancer treatments must keep up with innovation," said Lance, a member of the energy and commerce health subcommittee. "Many patients are now using promising oral treatments, but are forced to pay astronomical out-of-pocket costs or forgo treatment altogether. We have to fix this disparity in coverage so cancer patients are making health care decisions based on the best information, not which treatment fits into outdated guidelines."

"Today's medicine allows some cancer patients the opportunity to take chemotherapy in the form of a pill at home rather than through an IV in the hospital; yet under the existing broken system, in some cases it is more costly to fill the prescription than spend hours in a medical facility under health care supervision," said Higgins, a member of the House of Representatives cancer caucus. "The Cancer Drug Coverage Parity Act levels the cancer drug playing field so patients can focus on fighting cancer, not fighting for coverage on life-saving medication."

Oral chemotherapy is becoming more common for many types of cancer. But, doctors and patients have found health insurance coverage for different types of cancer treatments is not uniform. Often, orally administered, anti-cancer medications are covered under a plan's prescription drug component, which often places a higher percentage of cost sharing on the patient.

Higgins said reform is needed. Oncologists suggest 35 percent of present research is focused on oral chemotherapy.

The measure is expected to be referred to the energy and commerce health subcommittee.

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