Baker bill to make oral cancer treatments more affordable

In In The News by Barbara Jacoby


After a long journey and much hard work, legislation that will require insurance companies to provide coverage for oral anti-cancer medications on the same level they do for intravenous treatments has been signed into law in Pennsylvania, announced Rep. Matt Baker, R-Wellsboro, author of the bill.

“This legislation was a long time in coming,” said Baker. “With more than 80,000 people per year receiving a cancer diagnosis in Pennsylvania, we needed to step up and make sure everyone has access to the best and most cutting-edge cancer treatments. This legislation will help make sure oral anti-cancer treatments receive the same insurance coverage as intravenous treatments. This kind of parity was missing before and that put many individuals in difficult financial situations when they were unable to pay for the oral medications their doctors prescribed.”

House Bill 60, now Act 37 of 2016, addresses the cost disparity between intravenous and oral anti-cancer treatments. Previously, intravenous anti-cancer medications were covered under a health plan’s medical benefit, often only requiring patients to pay a minimal fixed co-payment; however, oral anti-cancer medications were covered under a health plan’s pharmacy benefit, and required patients to pay a percentage of the total cost of the drug, generally between 25 percent to 30 percent.

With the average cost for a one-month supply of an oral anti-cancer medication costing $7,000, some cancer patients in Pennsylvania were left with a coinsurance cost of between $1,400 and $3,500 per month.

“I am thrilled for all those who will benefit from this legislation,” said Baker. “I have met many people through the process with this legislation who reached out to me with their stories, and to be able to provide help for them through this bill is an honor. I am thankful my colleagues and the governor worked in an expedient manner to get this bill passed into law this session.”

Baker said Pennsylvania now joins more than 40 states and Washington, D.C., in having enacted legislation to control out-of-pocket costs for cancer patients.