By Susie Novis Durie & Brian G.M. Durie
October 26, 2017 at 5:00 am ET
When it comes to a cancer, there are few among us who can say they haven’t been touched by the disease. Whether it’s personal, or news of a family member or friend, the impact of a diagnosis is far too common.
We founded the International Myeloma Foundation more than 25 years ago when Susie’s late husband, Brian Novis, was diagnosed with multiple myeloma. Our ultimate mission was to find a cure and to empower patients and caregivers through education, caregivers and inform health care providers about the disease.
Much has changed in the decades since, and scientific progress has completely altered how we treat and look at all forms of cancer. What once was a fatal diagnosis is now in many cases a chronic disease — and patients are living longer, and leading happy and fulfilled lives.
But this progress can only continue if patients have fair and equal access to all available anti-cancer medications. While we have accomplished much, there is still more to do.
That is why IMF is leading the charge in advocating for passage of legislation at the federal level to bring equality to the various types of anti-cancer treatments and the way patients and their insurance companies pay for them.
Why is this needed? Despite major advances in the way we treat cancer, the insurance industry hasn’t kept up in terms of their coverage plans.
Oral anti-cancer medications have become far more common in recent years, and that trend will continue to grow with oral chemotherapy drugs making up approximately 35 percent of treatments in the research and development pipeline. These medications are often the only option for some patients, and can offer many benefits including fewer of the side effects so often associated with traditional chemotherapy.
But despite that, the insurance industry segments the way they cover the cost of the various forms of treatment. Right now, most insurers place IV treatments within their plan’s medical benefit, while oral chemotherapy is placed under a plan’s prescription drug benefit. The problem with that discrepancy is that it often leaves a majority of the cost for the oral treatment in the hands of the patient, while the out of pocket cost for IV treatment is minimal.
That can mean patients using IV treatment will likely pay for the cost of a doctor’s visit, in the amount of 25 to 50 dollars.
For the patient needing oral treatment, that number is multiplied dramatically, often meaning hundreds, even thousands of dollars out of their own pockets — despite having insurance coverage.
The high cost for oral medications can put much needed and beneficial treatments out of reach for patients — with nearly 10 percent having to forgo treatment altogether. To put it simply, it’s unfair and unacceptable.
H.R. 1409 — the Cancer Drug Parity Act — would change that by ensuring that coverage for self-administered oral chemotherapy is provided by insurers at a cost no less favorable than the cost of IV, port administered or injected anti-cancer medications. This doesn’t add a new benefit for insurers, it simply means that all cancer treatments are covered in the same way with equal cost sharing for all patients.
This legislation makes sense, and is gaining support among both parties in Washington. At a time where the debate over healthcare is so divided, this is one step forward in making sure that cost doesn’t get in the way of another patient beating the odds and beating cancer.
Most Americans agree this is important legislation to enact, as 43 states have passed similar bills in their state legislatures. Those laws cover state regulated insurance plans, and by passing H.R. 1409, lawmakers will ensure that all Americans with federally regulated plans have the same options should cancer treatment become necessary for them or a loved one.
No one chooses to get cancer, and no one should have to choose between effective treatments and life’s other necessities.
We urge Congress to do the right thing for cancer patients and pass H.R. 1409 — to ensure that we continue to make progress not only in the fight against the disease, but in the ability for all to have access to the treatment they need.
Susie Novis Durie is the president and CEO of the International Myeloma Foundation. Brian G.M. Durie, M.D. is the chairman of the board for the International Myeloma Foundation.
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