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Patients & Healthcare Professionals

Modernizing Insurance Coverage to Keep Pace with Medical Innovation

Oral Treatments Are The Future

Oral cancer treatments account for roughly 25% of the cancer drugs in development, according to a study by the National Community Oncology Dispensing Association.

Oral cancer medications are often more convenient for patients to take.

In many cases, there is no alternative to oral medication.

Yet, Access Barriers Exist For Patients

Higher out-of-pocket costs increase the likelihood that patients don’t fill prescriptions, according to a study by Avalere Health and The West Clinic.

Many health plans require patients to pay higher coinsurance or copays for oral cancer medicines.

Some 84% of oncologists said high out-of-pocket costs influenced what medicines they prescribe, according to a national survey conducted by researchers at Tufts University, Baylor University and the University of Michigan.

In the same survey, 64% of oncologists said reimbursement rules for oral chemotherapy limited their ability to offer those therapies.

Parity Legislation Works

Since 2007, 44 states and the District of Columbia have enacted laws preventing insurance companies from applying different co-pays to oral cancer medicine.

The proportion of prescriptions filled at $0 for oral cancer medicines jumped to 53% from 15% in states that enacted parity legislation, according to a study in the Journal of the American Medical Association (JAMA).

There is no evidence that insurers incurred additional costs as the result of this increased access to cancer care, according to the same study.

The Cancer Drug Parity Act would protect the approximately 100 million patients not covered by these state laws.