It seems to defy common sense, but taking a pill can be more expensive for a patient than a trek to the hospital for intravenous (IV) medication. Because many health insurance companies cover the cost of administering treatments, while pills are usually covered by prescription plans, those who choose convenient oral medications may end up paying a lot more of the overall expense out of their own pockets.
This inequality stems from the complexities of health care coverage, including issues with medical and pharmacy benefits, Medicare plans, the rise in available oral therapies and the high cost of certain drugs.
More than twenty states now have “oral parity laws,” which require insurance companies to provide equal coverage for both IV and pill treatments. But the majority of states do not have such laws in place to protect patients. To adequately address this disparity, Congress must pass the Cancer Drug Coverage Parity Act (HR2746), according to the Association of Community Cancer Centers, a cancer education and advocacy organization.
Drug coverage is one of the leading challenges for cancer patients, according to the Community Oncology Alliance. And with advancements being made daily in therapies for cancer—and other diseases—oral treatments will only become more common.
In many cases, oral therapies can help improve patient quality of life, by allowing them to continue their daily activities, including employment, without regularly scheduled hospital visits for their medications. Aside from convenience, oral drugs also save the health system in man-hours and equipment costs. And some of the latest innovative oral therapies are making real differences in patient outcomes, helping to turn deadly diseases into more manageable, chronic conditions.
Politicians are starting to realize how essential these advances are for patients. In November, Niagara Frontier Publications reported that Democratic New York Congressman Brian Higgins spoke on the floor of the House of Representatives on behalf of the issue. ”Orally administered anti-cancer drugs are becoming the standard care for certain types of cancer, as a promising alternative to traditional chemotherapy, which is administered through the vein,” Higgins said as he presented H.R. 1801, the Cancer Drug Coverage Parity Act, to the House. “It is also driving some of the most exciting research in fighting cancer. Thirty-five percent in the oncology pipeline are oral chemo drugs.”
Voters can get in on the cause by encouraging their congressmen to support oral parity, so patients have the freedom to benefit from the most innovative cancer drugs. As Higgins pointed out to the House, “Cancer patients should choose a course of treatment based on what they and their doctor believe will work best.”