Legislation ensures cancer patients have equivalent access to oral chemotherapy
Congress members Brian Higgins (D-NY-26), Brett Guthrie (R-KY-2), Doris Matsui (D-CA-6) and Gus Bilirakis (R-FL-12) announced introduction of the Cancer Drug Parity Act, a bipartisan bill requiring health insurance plans that cover intravenous and injectable cancer medications to also cover orally administered cancer medications at the equivalent rate.
“Innovative research has led to more effective and accessible treatment options for cancer patients, but insurance coverage hasn’t kept pace,” said Higgins, who also serves as chair of the House cancer caucus. “The Cancer Drug Parity Act levels the costs, allowing patients and doctors, not insurance companies, to decide the best course of treatment, removing the cost discrepancy as a factor in cancer care.”
Guthrie said, “Due to great innovation, many cancer treatments can now be taken orally by a patient themselves, and I believe we must ensure these patients have full access to these important drugs. Americans suffering from cancer should not have to choose between one treatment option or another based on how their insurance classifies each treatment. The Cancer Drug Parity Act will fix the discrepancy between cancer treatment drugs that are orally administered and those that are intravenously or injected, and will allow patients and doctors to choose the treatment that is right and most effective for them.”
“Insurance companies shouldn’t be allowed to pick and choose what kind of treatment a cancer patient should receive – that should be left up to the medical professionals,” Matsui said. “That’s why this bipartisan, bicameral legislation is so critical, and Congress must pass this bill to address the disparity in cancer coverage. It’s time to put the decisions back in the hands of doctors and patients.”
“Cancer patients should have access to whichever treatment gives them the best chance to fully recover,” Bilirakis said. “Technological advancements are improving patient outcomes while minimizing side effects. Patients deserve to benefit from these advancements. This important bill addresses this problem and enables patients to keep their primary focus on getting well.”
Oral chemotherapy is increasingly becoming a standard treatment option for cancer doctors and patients, representing approximately 35 percent of the oncology development pipeline. However, insurance coverage for cancer treatment has not kept up with science.
Under current law, traditional IV/injectable treatments are routinely covered under the medical benefit component of a health insurance plan, while orally administered anti-cancer medications are generally covered under the prescription drug component, which often results in a considerable disparity in cost.
Additional original cosponsors on the House of Representatives bill are: Reps. Derek Kilmer (D-WA-6), Brian Fitzpatrick (R-PA-1), Peter King (R-NY-2), Jerry Nadler (D-NY-10), Peter DeFazio (D-OR-4), Alcee Hastings (D-FL-20), Pete Olson (R-TX-22), Debbie Wasserman Schultz (D-FL-23), Will Hurd (R-TX-23), Ami Bera (D-CA-7), Tom Cole (R-OK-4), Ro Khanna (D-CA-17), Michael McCaul (R-TX-10) and Eleanor Holmes Norton (D-DC). A similar bill, S.741 led by Sen. Tina Smith (D-MN) and Sen. Jerry Moran (R-KS), was also introduced this week in the U.S. Senate.
“The exciting advancements in cancer research mean that many patients now can live with diseases that just a few years ago would have taken their life,” said Eunice Wang, M.D., chief of leukemia at Roswell Park Comprehensive Cancer Center. “But the treatments we develop are only good if patients have access to them. We have to eliminate remaining loopholes to make sure all patients have proper insurance to equally cover oral medications that have revolutionized cancer treatment.”
“Pioneering research in precision medicine is transforming the way cancer is treated. Even with these breakthroughs, far too many cancer patients face burdensome out-of-pocket costs and cannot access their treatments because insurance rules have not kept pace with innovation,” said Louis J. DeGennaro, Ph.D., president and CEO of The Leukemia & Lymphoma Society. “The Cancer Drug Parity Act will ensure that patients across the country experience the same cost-sharing for all cancer treatments, allowing cancer patients to have equal access to the treatments recommended by their physicians. The Leukemia & Lymphoma Society applauds Rep. Higgins, Rep. Guthrie, Rep. Matsui and Rep. Bilirakis for their leadership on behalf of cancer patients, and looks forward to working with Congress to move this important bill forward.”
Organizations supporting the bill include: AIM at Melanoma, American Cancer Society Cancer Action Network, American Society of Hematology, American Society of Clinical Oncology, Aplastic Anemia and MDS International Foundation, Association of Community Cancer Centers, Association of American Cancer Institutes, Astellas Pharma US, Cancer Support Community, Celgene, Community Oncology Alliance, Dana Farber Cancer Institute, Debbie’s Dream Foundation: Curing Stomach Cancer, Facing Our Risk of Cancer Empowered (FORCE), Fight Colorectal Cancer, Genentech Inc., Glaxo Smith Kline, Hematology/Oncology Pharmacy Association, International Myeloma Foundation, Karmanos Cancer Institute, Leukemia & Lymphoma Society, Lymphoma Research Foundation, National Brain Tumor Society, National Patient Advocate Foundation, Oncology Nursing Society, Ovarian Cancer National Alliance, Patient Services Inc., Roswell Park Cancer Institute, Susan G. Komen, Takeda Oncology, The Ohio State University Comprehensive Cancer Center – James Cancer Center and Richard J Solove Institute, Zero – The End of Prostate Cancer, and the Patients Equal Access Coalition.