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Cancer treatment parity bill wins over mandate-averse Utah lawmakers

Published February 19, 2013 5:12 pm

Insurers oppose the measure but can't prove it would cause spike in insurance prices.
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The Senate Business and Labor Committee on Tuesday unanimously approved a bill that would require insurers to cover oral cancer drugs the same way they cover infusion drugs.

The insurance industry opposes a mandate, but did not provide any data showing the measure would cause a bump in health insurance prices.

At least 21 states have passed similar "oncology parity laws," and states that monitored premiums found no material change, said Sen. Curt Bramble, R-Provo, sponsor of SB189.

That, coupled with moving testimony from patients forced to shell out as much as $5,000 a month for life-saving therapies, helped conservatives move past philosophical reservations about mandates.

"I don't see this as a mandate bill," said Sen. Deidre Henderson, R-Spanish Fork. "I see this as parity...to me this looks like a glaring loophole, a mistake that needs to be fixed."

Chemotherapy pills are increasingly favored by oncologists over intravenous chemo delivered through a patient's vein. The "designer" drugs target cancer cells and the biological pathways through which cancer spreads, sparing healthy cells. And they are easier on patients, because they can have fewer debilitating side effects and don't require a trip to a clinic.

Both oral and IV chemo are "very expensive," said Nitin Chandramouli, an oncologist with Utah Cancer Specialists and president of the Utah Society of Oncologists. "Cancer is expanding rapidly. The science is expanding rapidly and so are the costs."

But oral chemo doesn't necessarily cost more than traditional infusion therapies — it's just treated differently by insurers, he said.

IV chemo is billed as a medical treatment, which may require patients to pay a small co-payment, while oral chemo is treated like a prescription drug and subject to rules that can stick patients with up to 50 percent of the bill.

"When patients come to us for treatment recommendations, we don't feel they should also be burdened with having to be part of the checks and balances on pharmaceutical companies," said Chandramouli. "They ought to be concerned only with getting better."






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