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Cancer Treatment Access Bills Gain Support across Florida House and Senate
Tallahassee, Fla. (February 25, 2013) – Legislation aimed at increasing access to life-saving, orally administered cancer treatments has gained the support of numerous co-sponsors as it works its way through the Florida House of Representatives and Senate. The bill, titled The Cancer Treatment Fairness Act, would protect patients from having to pay higher out-of-pocket costs for a cancer medication that is taken by mouth than for a cancer medication that is administered intravenously (IV). The proposal applies to plans that already cover cancer treatment; it does not require health plans to cover cancer treatment.
“These patients and their families are literally fighting for a life, and we should do everything we can to make certain that our insurance system treats them with compassion, respect and fairness,” said Representative Debbie Mayfield, sponsor of the House legislation, HB 301. “The choice between oral or intravenous treatment should be left to the patient and his or her doctor and devoid of financial pressure that result from unnecessary and archaic insurance coverage laws.”
Under the current insurance benefit design in Florida, patients who receive oral medications to combat cancer may face between hundreds and thousands of dollars in out-of-pocket expenses each month while undergoing treatment. However, cancer patients who receive their treatment by IV are typically responsible for covering just the cost of an office visit co-payment—usually $20 to $30—when they receive their IV-administered medication in a medical facility. This disparity exists because coverage for an IV-administered cancer medication is typically provided under a plan’s medical benefit, whereas orally administered cancer medications are covered by a plan’s pharmacy benefit.
Such high cost-sharing sometimes forces patients to choose a less appropriate treatment or, worse, to forego their prescribed medication. In many cases, there are no other treatments that can be substituted for the prescribed oral medication, as most cancer treatments do not come in both an oral format and an IV format. In such cases, the choice to incur a financial burden for an oral medication becomes a life or death decision. Yet orally administered medications may help patients avoid financial instability, as the convenience of orally administered medication may help reduce missed days at work for patients and their caregivers. This may diminish the likelihood of job loss and related financial struggles and may also lead to a reduced reliance on short- and long-term disability.
“Our focus should be on the patient and ensuring that our laws keep pace with advancements in medicine in a way that makes sure to treat patients fairly,” said Senator Lizbeth Benacquisto, sponsor of the Senate legislation, SB 422.
Chief Financial Officer Jeff Atwater became involved in this issue after Floridians called on his Division of Consumer Services to help them reduce the high out-of-pocket expenses required to obtain the orally administered cancer treatment recommended by their doctor. In one recent plea for help, a consumer’s co-payment was $45 for IV-administered cancer treatment. But when he went to fill the prescription for the orally administered version prescribed by his doctor, he learned that he now was required to pay $2,300 monthly for the same medication. In response, CFO Atwater supports legislation that requires insurers to cover orally administered cancer treatment in the same manner as IV-administered cancer treatment.
“Floridians who are fighting cancer should be able to focus on beating the disease without added anxiety over whether they can afford the form of treatment recommended by their doctor,” CFO Atwater said. “My office has received calls for help from consumers who were disturbed and disheartened by this unfair policy. Along with the sponsors of this legislation and on the behalf of all Floridians battling cancer, we will work to remedy this injustice.”
If the bill becomes law, Florida will join 21 other states, plus the District of Columbia, in addressing a longstanding disparity in access to orally administered cancer treatment. The bill has broad support from multiple patient and health advocacy organizations, as well as physicians and nurses in the oncology field.
Bipartisan co-sponsors of SB 422 include Senator Joseph Abruzzo, Senator Rob Bradley, Senator Dwight Bullard, Senator Jeff Clemens, Senator Nancy Detert, Senator Greg Evers, Senator Audrey Gibson, Senator Alan Hays, Senator Gwen Margolis, Senator Joe Negron, Senator Wilton Simpson, Senator Darren Soto, Senator Jeremy Ring, Senator Kelli Stargel, Senator Geraldine Thompson, Senator Anitere Flores, Senator Eleanor Sobel, Senator Dorothy Hukill, Senator Thad Altman, Senator Christopher Smith, and Senator Miguel Diaz de la Portilla.
Co-sponsors of HB 301 include Rep. Jeanette Nuñez, Rep. Ben Albritton, Rep. Halsey Beshears, Rep. Jason Brodeur, Rep. Matthew Caldwell, Rep. Michael Phillip Clelland, Rep. Katie Edwards, Rep. Mike Fasano, Rep. Joseph Gibbons, Rep. James Grant, Rep. Charles David Hood, Rep. Mia Jones, Rep. Mike La Rosa, Rep. MaryLynn Magar, Rep. Kionne McGhee, Rep.Cary Pigman, Rep. Elizabeth Porter, Rep. Jake Raburn, Rep. Holly Merrill Raschein, Rep. Ronald Renuart, Rep. Kenneth Roberson, Rep. Richard Stark, Rep. Greg Steube, Rep. Linda Stewart, Rep. Charlie Stone, Rep. David Santiago, Rep. Karen Castor Dentel, and Rep. James Waldman.
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