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Congressman Higgins Introduces the Cancer Drug Coverage Parity Act

May 12, 2009
Press Release

Today, Tuesday, May 12, 2009, Congressman Brian Higgins (NY-27) will introduce the Cancer Drug Coverage Parity Act, a bill to require health insurance coverage for intravenous/injectable and orally-administered cancer pills at the same rate.

“Coverage has not kept up with the quickening pace of scientific discoveries and cancer patients are paying the price,” said Congressman Higgins, a member of the Ways and Means Committee and the House of Representatives Cancer Caucus. “This will place cancer drugs on a level playing field in terms of affordability and allows patients to focus on beating the disease not breaking their budget.”

Smart drugs are designed to navigate the bloodstream with precision to kill and stop the growth of cancer cells. Radiation and chemotherapy are effective in killing cancerous cells, but also kill many healthy cells, weakening a patient’s immune system.

Because of their effectiveness, smart drugs are becoming a more common and acceptable treatment for cancer patients. Smart drugs are often administered orally, and many do not have an intravenous or injectable equivalent. Health insurance often covers oral drugs under a patient’s prescription drug plans which are generally not as comprehensive and financially feasible as the coverage for IV drugs. This disparity can leave cancer patients choosing between paying for orally administered smart drugs which can be taken at home but can cost upwards of $50,000 a year or sitting hours in a health facility while they undergo lengthy and difficult IV treatments.

Why is this change necessary?

  • Improves quality of life for cancer patients: Cancer treatments are excruciating. While orally administered anti-cancer drugs are not without side effects, equal access to these drugs can alleviate suffering and improve outcomes for many cancer patients.
  • Provides greater access to life-saving treatments: Drug coverage is one of the top problems for cancer patients. The disparity in coverage between intravenous/injectable treatments and orally administered anti-cancer pills further complicates this problem. Cancer patients should not have to wage a fight on coverage for a treatment if the treatment’s merits are proven.
  • Catches up with science: Our country’s biomedical research program is the envy of the world. The next generation of cancer drug treatments, largely resulting from that research, will be more complex and tailored to the particular needs and genetic disposition of individual patients, with smart drugs or pills, growing as a preferred treatment method. Our nation’s health system should catch up with where science is taking us.

Since 2007 several states, including Oregon, Colorado, Minnesota, Montana, Washington, Oklahoma and Hawaii, have enacted their own cancer drug parity laws. Congressman Higgins’ bill would create parity nationwide.