Oral Cancer Drug Parity

Many of us have discovered that oral drugs that we take at home, like Revlimid or Thalidomide, can cost us much more than intravenous (IV) drugs, like Velcade, delivered in the doctor’s office or a clinic. There are various reasons for the difference, including deductibles, co-pays, annual or lifetime maximums, and the “donut hole.” The costs can be so staggering that many patients simply don’t fill their prescriptions.

So why not just use IV chemotherapy instead of oral meds? (1) For some patients, oral meds may very well be the best medical treatment, especially with the newest oral meds; (2) It is SO much more convenient for the patient (us) to take a pill once a day instead of sitting in a clinic for an infusion. We can work, and travel, and live fuller lives, without being tied to a clinic; (3) For some patients, the nearest clinic may be many miles away; and (4) In some cases the oral drug may cost the health care system less, considering the much higher number of office visits required for IV therapy.

Fourteen states have now enacted laws requiring insurers to cover oral drugs on terms as favorable as they cover IV drugs. HR 2746, the Cancer Coverage Parity Act of 2011, is intended to fix the problem at the federal level, eliminating the need for the remaining states to enact their own legislation.

After running the Marine Corps Marathon yesterday, I stayed in Washington to help the International Myeloma Foundation (IMF) and the Leukemia and Lymphoma Society (LLS) bring this issue to the attention of a few congressmen and senators. Today we visited:John Martin, Legislative Director for Congressman Phil Roe, MD (R-TN);
Paul N. Balzano, Legislative Director for Congressman K. Michael Conaway (R-TX);
Caira Woods, Legislative Health Fellow for Congressman Frank Pallone, Jr. (D-NJ);
Pat Pelletier, Legislative Correspondent for Congressman John Kline (R-MN); and
Elizabeth Hoffman, Legislative Assistant for Congressman John R. Carter (R-TX)I’ve never done anything like this before, and was actually more apprehensive about these meetings than I was about Sunday’s marathon – I didn’t sleep well last night. But I found that I liked it, especially after the first person was warm and affirming. Everyone was cordial, at the very least. In most cases, the issue was new to the staff person with whom we spoke. They were there to be educated and they learned something. I enjoyed it and will sleep well tonight!

Tomorrow we have six more meetings. I believe five are with congressional staff, and hopefully one with an actual senator. Can’t wait.