Forty-two states have now passed laws that require insurers to provide parity in cost-sharing between what a patient pays to receive an intravenously administered cancer treatment and an orally administered cancer treatment. However, federal action is needed to protect the 93 million Americans whose employer-sponsored health plans are not state-regulated.
While states regulate health plans funded through insurers, the federal government regulates those where the employer assumes the financial risk for employee health benefits, otherwise known as self-funded plans. Today 63 percent of the 147 million covered American workers are enrolled in self-funded plans.
The state laws prevent cancer patients from paying more for oral medications than they would for therapies given intravenously at a treatment center. Cancer patients who face higher costs for their oral therapies are less likely to adhere to their treatment regimen, according to one study.
“Oral therapies are the future of cancer care, and we need to ensure that every patient has affordable access to those treatments,” Meghan Buzby, former senior director of advocacy at the International Myeloma Foundation, said. “We need oral cancer therapy parity laws in all 50 states and at the federal level.”
Oral cancer therapies are the future of cancer care, and we need to ensure that every cancer patient has affordable access to those treatments.
Last year, the House of Representatives and the Senate introduced bills that, if passed, would protect those 93 million Americans from outdated insurance practices. So far, a bipartisan group of 117 representatives and 20 senators have co-sponsored the Cancer Drug Coverage Parity Act.
“It’s a bipartisan effort. That’s something we’ve never seen before in our oral parity efforts,” Buzby said. The bill is positioned with strong bipartisan support to potentially be included in future health care legislation. “We’re making real strides in Congress this year.”
Cancer patients and advocates can help by telling their senators and representatives to support H.R. 2739 and S. 1566. The International Myeloma Foundation has set up a website to make it easy and has organized the Patient Equal Access Coalition where advocates can learn more about the bills.
Even if a federal oral parity law is enacted, additional action would be needed to provide the 56 million seniors covered under Medicare from unequal access. “We’ve been operating our advocacy efforts under the hope that if we pass this for commercial plans, then that would prove it could work in the Medicare population as well,” Buzby said.
Visit the International Myeloma Foundation’s Action Center today to ask your federal legislators to support federal cancer therapy coverage parity legislation.