WASHINGTON, D.C. --- U.S. Representatives Leonard Lance (NJ-07) and Brian Higgins (NY-26) have introduced bipartisan legislation called the Cancer Drug Parity Act (H.R. 1409) that would require health insurance plans that cover traditional chemotherapy to provide no less favorable coverage for prescribed, orally-administered anticancer medications. With the rising usage of oral medication by cancer patients, Lance believes this reform to coverage options will lower out-of-pockets costs for patients.
“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so cancer patients are making health care decisions based on the best information, not which treatment fits into outdated guidelines,” said Lance, a member of the Energy and Commerce Health Subcommittee.
Lance has built a record in Congress on cancer-related issues. Lance played a major role in the 21st Century Cures Act becoming law last year and Lance’s Breast Cancer Patient Education Act was put into implementation last year. Lance has again recruited Susan G. Komen to help get this legislation through Congress. “We want to thank Congressman Lance for introducing this vital legislation on oral parity, which we've already passed in the state of New Jersey,” said Director of Community Health of Komen North Jersey Tina Jacobs, a resident of Summit, New Jersey. “We’ve seen the impact of this bill in our community, including especially huge benefits for women with metastatic breast cancer, which is why Komen and our Affiliate are proud to support this bill.”
Lance is trying to build a bipartisan consensus behind ideas that will lower costs across the health care market. Rep. Brian Higgins, a member of the Ways and Means Health Subcommittee, will be the lead Democrat on Lance’s bill. “Today’s medicine allows some cancer patients the opportunity to take chemotherapy in the form of a pill at home rather than through an IV in the hospital; yet under the existing broken system, in some cases it is more costly to fill the prescription than spend hours in a medical facility under health care supervision. The Cancer Drug Parity Act levels the cancer drug playing field so patients can focus on fighting cancer, not fighting for coverage on life-saving medication.”
Oral chemotherapy is becoming more common for patients with many types of cancer. Doctors and patients though have found that health insurance coverage for different types of cancer treatments is not uniform. Often orally-administered, anti-cancer medications are covered under a plan’s prescription drug component that often places a higher percentage of cost sharing on the patient. Reform is needed, as oncologists suggest 35% of present research is focused on oral chemotherapy. The measure has been referred to the Energy and Commerce Health Subcommittee where Lance is a member.
The national Susan G. Komen organization also backs the duo’s legislation. “Every breast cancer patient should have access to the right treatments without undue economic or regulatory burdens to that care. Oral chemotherapy allows patients to be with families or productive on their jobs, rather than spending hours at a clinic taking traditional chemotherapy, and should be available at no additional cost,” said Komen Interim CEO Ellen Willmott. “We will work with Congressman Lance to pass the Cancer Drug Parity Act.”