Missouri Increases Access to Effective Treatments

To ensure nationwide access to oral cancer therapies, a federal law is necessary.

Missouri Gov. Jay Nixon has signed a law that will provide cancer patients with more affordable access to oral chemotherapy treatments, becoming the 28th state to enact an oral parity law.

Starting next year, cancer patients in Missouri will not be charged more than $75 for a one-month supply of oral chemotherapy after they have met their health insurance deductible.

“No Missourian battling cancer should have to break the bank in order to get the medicine they need,” Nixon said in a statement.

Currently in Missouri, intravenous (IV) chemotherapy—which is injected into a patient during a visit to a hospital or outpatient clinic—is covered as a medical benefit under a patient’s health insurance. Oral chemotherapy, however, is covered as a prescription drug benefit.

Today Congress has a unique opportunity to improve the quality of care for thousands of cancer patients across the country.

As a result, Missouri cancer patients are paying an estimated average of $2,000 to $5,000 per month for oral chemotherapy, according to the American Cancer Society. By contrast, IV cancer treatments usually only incurs an office visit co-pay, which could be as little as $20 for each appointment.

“It’s very challenging to their pocketbook,” Mary Kruczynski, director of Policy Analysis at Community Oncology Alliance, said. The challenge can be especially difficult for patients prescribed a combination of chemotherapies. “Some of them have to decide every month which drug to choose.”

Oral chemotherapies are effective, do not require patients to make appointments for their treatment and may even have fewer side effects than IV chemotherapies. These benefits improve quality of life for patients, allowing them to be more productive members of society.

“The average employee with cancer misses 26 days of work annually going to a hospital to get the IV chemo,” Missouri State Rep. Shelia Solon, who sponsored the bill, told the Missouri Times. “They miss an additional 18 days because of side-effects which often don’t occur with the pill version of the treatment.”

“Cancer-killing oral treatments have mitigated many of the side effects. This allows people to work,” Debbie Kersting, executive director of the Gateway Chapter of the Leukemia and Lymphoma Society, said. “After a diagnosis, they can return to as normal a life as possible.”

Some opponents of the bill in Missouri feared it would increase insurance premiums. But a financial analysis found that premiums would only rise by an average of 57 cents per person per month.

In the end, the passage of an oral parity bill in Missouri will provide cancer patients with access to more treatment options. It’s also another example for lawmakers in states that have not enacted similar bills. While several other states are in the process of introducing similar bills, progress is slow.

To ensure that patients nationwide have equal access to oral cancer therapies, a federal law is necessary. On April 26, 2013, Rep. Brian Higgins and Rep. Peter King introduced the Cancer Drug Coverage Parity Act. If enacted, the legislation would require insurers that cover IV chemotherapy to provide the same coverage for oral medications.

Today Congress has a unique opportunity to improve the quality of care for thousands of cancer patients across the country.

Kersting knows these oral parity laws make a difference in patients’ lives. “It puts affordable, effective cancer treatment in the hands of patients.”