Raleigh, N.C. — The House voted Tuesday night to require insurance companies to offer the same coverage and co-pays for newer, pricier oral chemotherapy drugs as they do for older, less-expensive intravenous chemotherapy drugs.
House Bill 306 sponsor Rep. David Lewis, R-Harnett, said that, while orally administered chemotherapy is becoming a treatment standard for many cancers, and in some cases is the only option, out-of-pocket costs for oral chemo drugs under many insurance plans are far higher than for IV drugs.
"Studies show that, when out-of-pocket costs are more than $200 per prescription, patients are three times more likely not to fill their prescriptions than if the cost was $100 or less," Lewis said.
Lewis told the House that 37 states have already passed some form of chemotherapy parity legislation, "and there is no empirical data in any state that such changes have caused insurance premiums to rise."
"The old one-size-fits-all cancer treatment no longer fits many families," he said. "We cannot deny our citizens a better quality of life."
The House passed the same bill in 2013, but Senate leaders refused to consider it.
Rep. Sarah Stevens, R-Surry, tried unsuccessfully to amend the bill to substitute a $500 cap on co-pays for oral chemo drugs, saying it's "impossible" for insurance companies to establish price parity because the drugs are administered in different settings.
In addition, she said, new federal legislation already caps individual out-of-pocket medical expenses at $6,600 for the year.
"Chances are, this is not going to be a problem for [an oral chemo patient] anyway," Stevens said, "because you’re going to meet your maximum deductible fairly quickly unless you have an extraordinary plan, and that’s a chance you chose to take."
Rep. Verla Insko, D-Orange, supported Stevens' amendment, but Lewis did not, and it failed 33-80.
Rep. Bobbie Richardson, D-Franklin, spoke in favor of the bill, saying said she had personally undergone oral chemotherapy. "It is much less debilitating on the person as an individual than the IV counterpart," she said.
The bill is not expected to add any cost to the State Health Plan, which already treats oral chemotherapy medicines the same as IV drugs.
The legislation passed easily, 104-10, and goes to the Senate.