By Jeff Fox
A local legislator’s bill to require parity in how insurance companies pay for chemotherapy is headed to the desk of Gov. Jay Nixon for approval.
“It’s a great day today,” state Rep. Sheila Solon, R-Blue Springs, said Thursday after the Missouri House of Representatives voted 147-6 for her bill. The Senate also has approved the measure, and Solon expressed optimism that the governor will sign it.
“This is one bill that there’s zero egos involved,” Solon said. “Everybody came together to do the right thing.”
Under Solon’s bill, on Jan. 1, 2015, Missouri would become the 29th state to require chemotherapy parity. Insurance companies that pay for intravenous chemotherapy also would have to cover those treatments when available in pill form.
Solon says that has any number of advantages. Many patients in rural areas often have to drive long distances for intravenous chemo. Also, the average intravenous chemo patient takes 26 days off work during the course of treatment and another 18 to deal with side-effects, she said, a problem that is lessened with the oral forms of treatment. Also, three out of four patients going to a cancer center for treatment go with a loved one who also might be taking time off work.
“This is a revolutionary new way that we’ll be treating cancer,” Solon said, adding that some new cancer drugs are coming out only in pill form.
Overall, she said, the change should mean better survival rates and a better quality of life for patients.
It also could make things easier for children, many of whom are deeply scared of needles and the rest of what comes with intravenous treatment.
“It’s very traumatic,” she said.
Insurance companies often view oral chemotherapy as a pharmacy benefit, often resulting in higher payments by patients. On the other hand, intravenous medication is viewed as a medical treatment, which usually leads to lower copays and the insurance company picking up more of the tab.
Until this year Solon’s bill hadn’t gotten out of committee. The insurance industry opposed the change, arguing that premiums would go up. Solon got a measure passed last year to have a legislative committee study the issue before this year’s session. Among other things, that group found little or no impact on insurance rates.
“And I think that’s what really got the momentum rolling,” Solon said.
The insurance industry also agreed to a cap of $75 a month – after the deductible is met – for patients’ out-of-pocket fees. Solon said studies show people begin to shy away from chemo if the out-of-pocket costs are much higher than that.
“This is one of those rare times when the stakeholders came together to do the right thing for Missouri,” Solon said.