Missouri cancer patients could soon find it more affordable to take chemotherapy pills under legislation signed by Gov. Jay Nixon.
Starting in January, patients could not be charged more than $75 for a 30-day supply of oral cancer drugs. The measure is intended to make the cost of oral chemotherapy, which typically has fewer side effects, more comparable to traditional intravenous treatments.
“No Missourian battling cancer should have to break the bank in order to get the medicine they need,” Nixon said in a written statement.
With the Democratic governor’s signature, Missouri joins 27 other states and the District of Columbia in enacting some form of cost control for oral chemotherapy.
The American Cancer Society estimates that Missourians on average currently pay between $2,000 and $5,000 for a month’s supply of oral chemotherapy. One drug used to treat lung cancer costs over $30,000 for a 30-day supply.
On the other hand, intravenous treatments typically cost a routine co-payment for a doctor’s visit, which can be as low as $20.
“For some people the cost has not even been in the realm of possibility and the $75 a month cap now makes it an option,” said Stacy Reliford, government relations director for the American Cancer Society.
Insurance companies typically view the oral drugs as a pharmacy benefit and the intravenous therapy as a medical treatment, which leads to the price disparity. Patients can often be required to pay half of the pharmacy benefit’s cost.
The $75 cap under the law could increase annually, but wouldn’t be able to rise above the consumer price index in a given year. The legislation applies to all insurance plans that provide coverage for cancer treatments.
Previous attempts to level the cost between cancer treatments stalled over concerns that insurance premiums would spike.
This year’s effort gained momentum after an actuarial analysis commissioned by lawmakers found that premiums could rise by an average of 57 cents per month if oral chemotherapy out-of-pocket costs were capped at the same amount paid for intravenous treatments. Average plans cost $350 per month, according to the report.
The legislation passed the Senate unanimously last month and the House gave final approval with a 147-6 vote on March 6. The bill was sponsored by Sen. Ryan Silvey, R-Kansas City.
“With more and more oral chemotherapy pills coming on the market, this legislation was needed to ensure insurance companies cover these medications in an equitable way,” he said.
The chemotherapy bill is SB668.