Free Mesothelioma Information Packet

News RSS Feed

Mesothelioma News Insurance Coverage Varies for Intravenous vs. Oral Chemotherapy

Monday, March 18th, 2013

Doctors and researchers say a pill taken orally is the future of chemotherapy, yet in many states, insurance companies tend to view the intravenous version as the most acceptable form of treatment, providing it for a low co-pay, while those who take an oral form of many popular chemo drugs must pay out of their own pocket.

A story aired on WJHG News in Northwest Florida profiles the attempt of a Florida man to get his state to jump on the bandwagon with 21 other states that have passed Fairness in Treatment laws, which cover both expensive forms of treatment equally.

Luke Webb of Miami, Florida was diagnosed with cancer five years ago and had to pay out-of-pocket for his oral chemotherapy drugs, which his doctors said were the best form of treatment for him. So this week, Webb went to Tallahassee to speak with legislators about the disparity in coverage, urging them to pass laws that will cover either form of chemo.

Doctors agree with Webb’s opinion that treating the two forms of chemotherapy differently just isn’t fair to patients. “If the best cancer care is in a pill form, it shouldn’t cost more than it would cost them if they were getting it in a IV form if it were available,” said a Florida physician, Dr. Wayne Taylor.

Legislator David Wood of Daytona Beach agrees and doesn’t understand why there’s a difference either. The politician has been taken oral cancer medication for the past several months and says it’s high time that treatments be handled equally.

“Somehow it’s cheaper to do it with a doctor and a nurse than to do it with a pill. That makes no sense. It’s counter intuitive,” said Wood.

The story points out that Oregon was the first state to pass a Fairness in Treatment law, doing so in 2007, but notes that the resistance to such laws is coming from managed care providers and HMOs, who are concerned about rising costs. Most studies show that when such laws are passed – treating oral and intravenous chemotherapy equally – the increased cost for insurers is about fifty cents per subscriber per month. Cancer patients are more than willing to pay the premium.

While many types of chemotherapy drugs are now offered intravenously only – including Alimta® for mesothelioma – researchers believe oral drugs are the wave of the future, which is why many believe that legislation like this is so vital. It’s likely that other states will begin to rally for similar laws in the near future, especially if Floridians are successful in making the change.

The rate of cancer in Florida is extremely high due to its large senior population, hence the importance of such legislation in The Sunshine State.