Oral Cancer Drug Insurance Parity Bill Gets OK from Gov. Pat Quinn

(Chicago, IL) — July 27, 2011. Governor Pat Quinn today signed legislation to ensure that health insurance benefits apply equally between oral and injectable cancer drugs, ensuring that cancer patients have more affordable and at times, necessary, treatment options available.

The legislation, House Bill 1825 sponsored by State Rep. Ann Williams (D-Chicago) and State Senator Heather Steans (D-Chicago), requires private health insurance plans that provide coverage for oral and intravenous chemotherapy to cover both at the same benefit level.

“Patients battling cancer shouldn’t have to forgo potentially life-savings treatments because of costs,” Quinn said. “This legislation will provide more affordable coverage options, so that patients can choose the best, most appropriate therapy to fight their cancer.”

Historically, chemotherapy drugs have been primarily administered intravenously. Today, many types of chemotherapy can be taken via a liquid, tablet or capsule, a less invasive alternative. In fact, oral chemotherapy is the only appropriate treatment for certain types of cancer, and can also provide an alternative for patients who have trouble responding to other treatments.

Many healthcare benefit plans have failed to change to ensure patient access to oral chemotherapy, forcing some cancer patients to pay higher out-of-pocket costs simply because their treatment is dispensed orally.

“Amazing advances in medicine have resulted in groundbreaking new therapies to treat all types of cancer – this includes oral chemotherapy options and targeted cancer drugs in pill form.” said Williams, the measure’s chief sponsor.

“We are simply providing for health insurance companies to structure their benefit plans to ensure patients have access to the most effective treatments available – regardless of the means of delivery of these drugs.”

The disparity in coverage for oral treatments is also a factor in deployment of “smart drugs” in cancer treatment. Traditional radiation and chemotherapy are effective in killing cancerous cells, but also kill many healthy cells, weakening a patient’s immune system.

Smart drugs are delivered orally and designed to navigate the bloodstream with precision to stop the growth of cancer cells, often avoiding damage to healthy cells. While these regimens are often more costly up front, they may be able to significantly decrease the amount of therapy time, increase positive outcomes and reduce longer-term costs associated with traditional intravenous treatments.

“This legislation is critical to ensure cancer patients can select the treatment therapy most appropriate for them rather than based on what insurance companies cover,” said Steans.

Despite the initial opposition of some leading insurance companies, lawmakers approved the legislation unanimously because cancer has touched so many lives that legislators understood the measure’s importance, according to Williams.

“We worked hard to get strong bipartisan support, which is how it got the momentum to pass unanimously,” said Williams. “Unfortunately, almost everyone has had their lives touched by cancer in some way, so my colleagues had a real understanding of what a positive impact this bill could have on patients dealing with cancer.”

Illinois joins other states that have enacted cancer drug parity laws including: Connecticut, Colorado, Indiana, Iowa, Hawaii, Kansas, Minnesota, Oregon, Vermont, the District of Columbia, and New Mexico.

Quinn, Steans, Williams, and all members of the Illinois General Assembly have rendered a genuine service to the public.

The measure takes effect Jan. 1.