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Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20150&cosponId=15897
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House of Representatives
Session of 2015 - 2016 Regular Session

MEMORANDUM

Posted: December 12, 2014 03:37 PM
From: Representative Matthew E. Baker
To: All House members
Subject: Oral Chemo Parity Legislation
 
In the near future, I will be re-introducing the Oral Chemo Parity legislation (former HB 2471) that will provide for equal access to chemotherapy treatments.

Over the years, cancer treatment methods have been changing. Traditional anti-cancer medications were primarily administered intravenously, attacking both cancerous and healthy cells alike. Conversely, orally administered anti-cancer medications have been developed more recently to target only cancer cells, having fewer side effects. Additionally, oral anti-cancer medications have shown to be far more effective for some forms of cancer.

Intravenous anti-cancer medications are typically covered under a health plan's medical benefit, often requiring patients to pay a minimal fixed co-payment. Orally-administered anticancer medications, however, are covered under a health plan's pharmacy benefit. Under the pharmacy benefit, oral anti-cancer medications are classified in the highest tier of a health plan’s cost-sharing system, requiring patients to pay a percentage of the total cost of the drug, generally between 25-30%. This creates an enormous financial barrier for patients to access orally administered drugs prescribed by their cancer physician for treatment.

Increases in out-of-pocket costs of anti-cancer medications can lead to a decrease in adherence to treatment, further risking patient health and making treatment longer, more expensive and less effective.

My legislation will prohibit insurance policies from placing oral anti-cancer medications on a specialty tier or charging a coinsurance payment for the medication, helping more patients afford a more convenient form of cancer treatment. As of August 2014, 34 states have enacted oral chemotherapy access laws.

I hope you will join in co-sponsoring this important legislation that will increase access for cancer patients. This legislation is supported by the Leukemia & Lymphoma Society. Thank you for your interest and support.

PREVIOUS COSPONSORS: BENNINGHOFF, CAUSER, HEFFLEY, MURT,
KNOWLES, V. BROWN, DAVIS, BOBACK, LONGIETTI, McCARTER, KOTIK,
D. COSTA, MILLARD, KILLION, WATSON, EVERETT, CUTLER, BARRAR,
GIBBONS, HARHART, DiGIROLAMO, ROCK, COHEN, DONATUCCI,
SCHLOSSBERG, KAUFFMAN, PICKETT, MATZIE, CLYMER, PETRI,
GINGRICH, SWANGER, BROOKS, GROVE, BIZZARRO, MILNE, DeLUCA,
ENGLISH AND SAMUELSON,



Introduced as HB60