MSV supports oral chemotherapy legislation

3 February 2012

MSV joined a coalition backing legislation to improve patients’ access to oral chemotherapy medications. Two bills have been introduced on the topic, HB 1273 and SB 450. The bills would require health insurance plans in Virginia that cover cancer treatments to provide coverage for orally administered anticancer medications on a basis no less favorable than coverage for intravenously administered or injected anti-cancer medications.

HB 1273 was reported favorably by the House Health, Welfare, and Institutions Committee. It was then forwarded to the Appropriations Committee, which will consider the budget impact the bill would have on the state health insurance plan. Hugh M. Bryan III, M.D., Medical Society of Virginia (MSV) president, expressed MSV’s support for the bill as it was considered by an Appropriations subcommittee on Feb. 2. The subcommittee has recommended favorable action on the bill to the full committee.

The Senate version, SB 450, is in a similar position as the House bill. SB 450 was approved on a 12-4 vote by the Education and Health Committee, and is now under the purview of the Senate’s Finance committee.

As background for legislators, the groups supporting the bills have explained that intravenous/infused anti-cancer medications are typically covered under a health plan's medical benefit. In this situation, patients are usually required to pay an office visit co-payment at the time of the visit. Orally-administered anti-cancer medications are covered under a health plan's pharmacy benefit. Under the pharmacy benefit, oral anticancer medications require patients to pay higher co-payments, which can sometimes be a percentage of the drug’s cost. This disparity restricts patient access to life-saving oral cancer therapies. When an oral treatment is determined most effective, patients are sometimes forced to make their treatment choice based on cost, rather than efficacy.

MSV has joined the Virginia Pharmacists Association, the Leukemia and Lymphoma Society, the American Cancer Society, the International Cancer Advocacy Network, the International Myeloma Foundation, the Virginia Association of Hematologists and Oncologists and the National Patient Advocate Foundation in support of the bills.