– Cancer patients who could have better health outcomes by taking certain oral medications are one step closer to having more affordable access to the medicine under legislation passed by the state House this week, said Rep. Tina Pickett (R-Bradford/Sullivan/Susquehanna), who voted for the measure.
“The fact that some oral medications can effectively treat certain forms of cancer is good news for many who struggle with this disease and want to avoid the harsh side effects of intravenous drugs,” said Pickett. “However, there have been some instances reported in which the cost of such treatment isn’t covered by some insurance plans. This legislation seeks to remedy that by allowing such treatments to be covered by the health portion of insurance, rather than the prescription benefit. This will help make the medication more affordable to those who need it.”
If House Bill 60
, which Pickett co-sponsored, is signed into law, patients would be able to pay a minimal and fixed co-payment for the oral form of the prescription, rather than a higher percentage of the medication, as required by some prescription benefit packages. The average cost for a one-month supply of an oral anticancer medication is around $7,000, thereby requiring some cancer patients to be left with a payment of between $1,400 and $3,500 per month.
This legislation would apply to private health plans that are not part of a self-insured network.
“By allowing such anti-oral meds to be covered and more accessible to patients, we can help to avoid some of the longer-term, costlier treatments with much harsher side effects,” Pickett said. “This will help lead to better health outcomes for these patients.”
This legislation mirrors a proposal passed by the House last year but it did not clear the state Senate. This session’s version now heads to the Senate for consideration. To date, 34 states have enacted similar legislation to control out-of-pocket costs for cancer patients, including all bordering states to Pennsylvania with the exception of West Virginia.
Representative Tina Pickett
Pennsylvania House of Representatives
Media Contact: Jennifer Keaton