Lawmakers outline chemotherapy measure

JEFFERSON CITY, Mo. -- Missouri health-care groups pressed state lawmakers Wednesday to bar insurers from charging higher co-payments and deductibles for chemotherapy medication taken in pill form, saying it would allow many patients to avoid having to go to a hospital or doctor's office for intravenous treatments.

A proposed bill would require insurance companies to charge the same fees for chemotherapy pills as they do for intravenous treatment. Insurers can charge higher fees for orally-taken treatments even if they are the only ones available, according to the American Cancer Society.

"The goal would be that a person battling cancer could still go to work every day, support their families and live a normal life," said Rep. Sheila Solon, R-Blue Springs, one of the measure's sponsors.

Solon said pill-form treatments can save patients from having to miss work to get treated at a hospital or doctor's office.

"We need to do anything to make that treatment easier for patients, especially in rural areas," said Sen. Brian Munzlinger, R-Williamstown.

Measures to require equal chemotherapy costs have already been introduced in the House and Senate this year. The bills would only affect health plans that provide coverage for both types of treatments.

Lawmakers considered similar legislation last year, but some expressed concern about potential insurance premium increases as a result of mandating the same patient out-of-pocket expenses for both treatments. In a compromise, they passed a measure commissioning an actuarial analysis of the effects of mandating equal costs for oral and intravenous treatments.

The analysis, published Dec. 20, found that premiums could rise by an average of 57 cents per month if such legislation were passed. Average commercial plans cost $350 per month, according the report.

The report said oral chemotherapy is often viewed as a pharmacy benefit by the insurance company, often resulting in higher payments by patients. On the other hand, intravenous medication is viewed as a medical treatment, which usually leads to the insurance company picking up more of the tab.

Twenty-seven other states and the District of Columbia have passed similar measures seeking to reduce the cost of orally-administered chemotherapy.