Washington, DC, March 9, 2017—Today the Patients Equal Access Coalition (PEAC) commends Congressmen Leonard Lance (R-NJ-7th District) and Brian Higgins (D-NY-26th District) on the introduction of the Cancer Drug Parity Act of 2017, H.R. 1409. This bill is a critical step toward improving access to anticancer treatments by requiring insurance companies to cover patient-administered and physician-administered anticancer drugs at the same cost to patients.
As the science surrounding cancer treatment continues to improve, the number of chemotherapy drugs that can be self-administered by patients continues to grow. In some cases, they may be the only drug proven to treat a specific type of cancer.
“Insurance coverage for cancer treatments must keep up with innovation. 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so cancer patients are making health care decisions based on the best information, not which treatment fits into outdated guidelines,” said Congressman Leonard Lance, the bill’s sponsor and a member of the House Energy and Commerce Health Subcommittee.
To date, insurance coverage policies for these drugs have not kept up with scientific advancement. Patients who rely on self-injectables or chemotherapy pills find themselves spending as much as $50,000 a year out of pocket because they receive the drugs from a pharmacy rather than in a doctor’s office.
“For patients living with cancer across the country, this bill will mean one less thing to worry about. They will no longer have to decide between the best treatment and financial stability, and can focus on what really matters: beating their cancer,” said Robin Levy, Senior Director of Public Policy and Advocacy for the International Myeloma Foundation (IMF). The IMF leads the coalition of organizations representing patients, health care professionals, cancer care centers, and industry.
The legislation will benefit thousands of cancer patients across the country, including Jody Winsick-Soluri of Hillsdale, New Jersey, a patient and advocate with the Leukemia & Lymphoma Society, who said, “Cancer patients like me need this law. I don’t have a choice. The only treatment for my cancer comes in the form of a pill, and I will need it for the rest of my life. High out-of-pocket costs don’t accomplish anything more than penalizing cancer patients who need these drugs to survive.”
“As providers, we are often forced to choose between the best treatment for patients, and what they can afford. This bill would eliminate the cost difference between self-administered and physician- or clinic-administered cancer drugs, and allow physicians to prescribe the most appropriate chemotherapy for the patient,” said Sarah Peters, a hematology/oncology pharmacist and president of the Hematology/Oncology Pharmacy Association.
The heavy financial burden often also forces patients to skip doses to save money, which impacts the drugs’ effectiveness and puts the patients’ lives at greater risk. “Part of our job as pharmacists is to make sure that patients are taking their medications as prescribed. However, due to the out-of-pocket costs of some oral and self- injectable chemotherapy, our patients cannot always comply. This bill would make these medications more accessible and improve the efficacy of the treatment,” Peters said.
The Cancer Drug Parity Act will dramatically improve the lives of cancer patients. Patients who previously could not afford these treatments will be able to access their life-saving effects. It will also make cancer treatments more practical for patients living in rural and underserved areas by reducing the need to drive long distances for a nurse or doctor to administer treatment.
“Cancer patients should be able focus on their treatment, instead of fighting for adequate coverage for life-saving medications,” said Congressman Brian Higgins. “The Cancer Drug Parity Act would ensure that oral chemotherapy treatments are covered at the same rate as more traditional intravenous (IV) and injectable treatments, so that insurance keeps pace with today’s medical advances.”
“Many of the newest and most effective cancer therapies are available only in pill form, so restricting access to oral medication can cut patients off from a therapy that may be the only viable treatment option for their particular cancer. That doesn’t make sense medically or financially,” said Dr. Candace Johnson, President and CEO of Roswell Park Cancer Institute. “Research has helped us to improve medical care dramatically, and our payment systems need to keep pace with that innovation.”
To date, 42 states and the District of Columbia have passed similar laws to increase access to these life-saving drugs. To expand this to all cancer patients in the country, we need a federal law that sets a standard across all states so that all cancer patients can access both physician and patient administered chemotherapy.
PEAC thanks Congressmen Lance and Higgins for their leadership and urges Congress to pass the Cancer Drug Parity Act.
The Patients Equal Access Coalition (PEAC) is a patient-focused coalition of 32 organizations representing patients, health care professionals, care centers, and industry, which have joined together to ensure that cancer patients have equality of access (and equality of insurance coverage) to all approved anticancer regimens including, but not limited to oral and intravenous drugs, injection, surgery, radiation, and transplantation. PEAC believes that every cancer patient should have access to the anticancer regimens recommended by their physicians and should not suffer from cost discrimination based on the type of therapy provided or the mechanism of delivery. For more information and a list of members, please visit our webpage: http://peac.myeloma.org.