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Senate of Pennsylvania
Session of 2015 - 2016 Regular Session


Posted: January 29, 2015 01:30 PM
From: Senator Robert M. Tomlinson
To: All Senate members
Subject: Oral Oncology Benefit Design
Please join me in cosponsoring legislation that would allow cancer patients, in consultation with their physician, to be permitted to select their best treatment option. Treatment options for patients should not be limited on the basis of how the therapy is administered.

For years, the mainstay of cancer treatment has been intravenous chemotherapy. This treatment is typically covered as part of an insured’s medical benefit. As the science of treating cancer has progressed, oral chemotherapy has emerged as an alternative treatment option.

Oral chemotherapy is a significant and growing option for the cancer patient. Oral chemotherapy is typically covered as part of the prescription drug benefit. This fragmented coverage means a patient normally will experience significantly different out of pocket costs based on how their treatment is administered.

My legislation requires health insurers to provide coverage for orally administered chemotherapy on a basis that are as least as favorable as an insured’s co-pay; coinsurance or deductibles are for intravenous or injected chemotherapy treatment.

Last session, it was introduced as SB 402 and cosponsored by Senators Pileggi, McIlhinney, Greenleaf, Mensch, Erickson, Costa, Brewster, Boscola, Farnese, Schwank, Yudichak, Washington, Tartaglione, Ferlo, Dinniman, Vulakovich, Leach, Fontana, Solobay, Yaw, Ward and Folmer.

Introduced as SB536