Oral chemotherapy bill passes House

HARRISBURG, Feb. 25 – State Rep. Mark Longietti, D-Mercer, on Tuesday voted for a bill that would require health insurance providers that cover intravenous cancer chemotherapy to cover oral chemotherapy treatment equally.

 

The bill (H.B. 60) passed the House and was sent to the Senate.

 

"Chemotherapy in pill form is the newest option for chemo. It is more convenient for patients because it can be taken at home and has fewer side effects, compared to the traditional intravenous chemotherapy, which also requires a hospital visit for its administration," Longietti said. "However, oral chemotherapy also is more expensive. This bill would put oral chemotherapy more in line with other chemotherapy treatments."

 

Intravenous chemotherapy treatments are usually covered under a health plan's medical benefit and require a minimal payment. Orally administered treatments are covered under a health plan's pharmacy benefit. Some insurance companies have placed orally administered treatments on "specialty tiers," requiring those who need the drugs to pay as much as one-third of the cost.

 

Typically, a person will pay $1,500 to $3,000 per prescription for a specialty tier drug, according to a study by the Pennsylvania Legislative Budget and Finance Committee. Longietti said this is unaffordable for many patients.

 

House Bill 60, which Longietti co-sponsored, would prohibit insurance companies from placing oral anti-cancer medications on a specialty tier or charging a co-insurance payment for the medication.

 

If the Senate takes action on the bill, and it is signed into law, Pennsylvania will join at least 34 other states that have enacted oral chemotherapy access laws.