Editorial: Reduce costs of fighting cancer
Though most cancer treatments are administered intravenously, patients can take medication orally as well, which often reduces the side effects of chemotherapy. That can help cancer patients keep living and working as they did before their diagnosis. But the oral medication is more costly than medicine administered through an IV.
Michigan should do what it can to lower those costs and offer a greater range of treatment to cancer patients.
Chemotherapy delivered by IV is covered under medical insurance benefits because patients receive that treatment under supervision in a medical facility. Oral treatment is covered under the pharmaceutical benefit of insurance plans, which often pays for far less of the cost and comes with a higher deductible that must be paid up front.
Some insurance companies require co-pays of 25 percent of the drug cost to fill prescriptions. That means a patient could end up spending thousands of dollars each month for oral medication when they could pay less out-of-pocket by undergoing IV treatment.
When patients speak with their doctors about a treatment regimen, they should be focused on the most effective way to cure a disease. It shouldn’t be a conversation about dollars and cents.
Michigan should join 43 other states in ensuring that patients pay the same out-of-pocket cost for IV and oral chemotherapy. Though bills were introduced in both the Michigan Senate and House in 2017, they were referred to committee and not acted upon by either chamber.
Andrew Schepers, director of Michigan government relations at the American Cancer Society Cancer Action Network, says the price discrepancy between the two treatment methods can lead to unsafe behavior.
For some cancers, such as stomach cancer, the oral treatment is actually far more effective, but patients often don’t have the money to fill their prescriptions regularly.
Schepers says this forces some patients to go off their prescribed treatment regimen and take their medication every other day to stretch the prescription. That works against a cure.
And though some fear that equalizing the deductible for IV chemotherapy and oral chemotherapy will cause insurance premiums to rise, Schepers says their fear is unwarranted.
Illinois enacted its chemotherapy fairness law in 2012, requiring that an orally administered drug have the same out-of-pocket costs for the patient as an intravenously administered drug. For patients, this has lowered oral chemotherapy costs from thousands of dollars per month to as little as $20. Following the law’s passage, insurance premiums did not change.
The popularity of oral chemotherapy treatment is growing. Nearly a quarter of cancer-fighting medication being developed will be administered orally.
Equalizing access to these life-saving treatments will help ensure that cancer patients get the treatment they need, not just the treatment they can afford.