Subject: Pa. law will help cancer patients with drug costs
From: "Eric Schwerin" <[email-masked]>
To: "Jeff Cooper" <[email-masked]>, "Hunter Biden" <[email-masked]>
Date: Sat, 2 Jul 2016 16:20:35 +0300

> http://www.philly.com/philly/health/20160702_Pa__law_will_help_cancer_patients_with_drug_costs.html <http://www.philly.com/philly/health/20160702_Pa__law_will_help_cancer_patients_with_drug_costs.html>
> 
> Pa. law will help cancer patients with drug costs
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> Pennsylvania this week became the 41st state to pass controversial legislation aimed at making oral cancer drugs more affordable for patients.
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> The bill, which passed both chambers of the legislature unanimously Thursday, was headed to Gov. Wolf, whose office said Friday that he would sign it into law.
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> Out-of-pocket costs for intravenous chemotherapy - which requires going to a medical office for infusions - are much lower than patients' costs for the more convenient oral medications. The new law equalizes the two.
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> Patient and physician groups who lobbied for the bill for three years cheered their victory, as did key sponsor Rep. Matt Baker (R., Tioga). "It has been a long road to get this legislation through the many hurdles," Baker said. "I am hopeful the governor will sign this legislation in all haste in order to finally bring about needed relief to so many cancer patients and their families."
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> So-called chemotherapy parity laws require private health insurers to cover oral drugs under "no less favorable" terms than infused chemotherapies, which are mostly older and less expensive medications.
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> Insurance companies usually cover intravenous chemo as a medical benefit because the drug is given in a hospital or doctor's office, and patients are charged $20 to $50. In contrast, pills are covered as a pharmacy benefit, with the patient chipping in as much as 25 percent of the price; the copay can run $1,400, and $3,500 a month for newer oral drugs.
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> While the new legislation prohibits such disparate coverage, it also says insurers may require prior authorization for a drug, and may "consider the medical necessity and cost of oral chemotherapy medications compared with" infused or injected drugs.
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> Matt Helfrich of Harleysville, a member of the Pennsylvania Cancer Treatment Fairness Coalition, said he is leery of that language because "it sounds like insurance companies have the ability to decide on parity or not."
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> But coalition leader Danielle Bunis, who works for the Leukemia and Lymphoma Society, said the prior authorization provision is standard.
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> "We worked really hard over the past year to come up with legislation that everyone can support," she said. "It's going to provide protection to patients in Pennsylvania that they didn't have before."
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> Various federal "chemo parity" proposals are now before Congress. While these address a glaring problem for patients, policy experts say the statutes do nothing to fix the fundamental problem - the astronomical costs of new cancer drugs. There is nothing in chemo parity laws that prevents insurers from passing on the added costs of oral drugs to all policy holders.
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> The average monthly cost for a branded oncology drug has doubled in the last decade to $10,000 a month - with no end in sight, according to market analysts.
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> University of Pennsylvania bioethicist Steven Joffe, who is also a pediatric oncologist, has written that the laws "sidestep the emerging national debate" about the true benefits of high-cost drugs. Increasingly, health policy experts say factors such as added survival time and the availability of cheaper medicines must be considered.
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> Bunis countered, "We recognize cost is a problem. But that's a much bigger problem that is going to take years to address. This legislation impacts patients today. Patients are dying because they can't afford their treatments."
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> [email-masked] <mailto:[email-masked]>
> 215-854-2720
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> @repopter
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> Published: July 1, 2016 — 2:17 PM EDT | Updated: July 2, 2016 — 1:07 AM EDT
> The Philadelphia Inquirer                         
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>  <>

Eric D. Schwerin
Rosemont Seneca Advisors, LLC
1010 Wisconsin Ave., NW
Suite 705
Washington, DC 20007
(202) 333-1880
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