Dive Brief:
- Federal legislators have introduced bills that would require health insurance companies to provide equally favorable coverage for oral chemotherapy treatment as they provide for intravenous chemotherapy.
- Such a requirement would have a high impact given that roughly a quarter of emerging chemotherapy drugs are oral.
- However, AHIP argues that the high price tags for such drugs will force an overall increase in premiums.
Dive Insight:
Such laws are not a new idea; 39 states and D.C. already have parity laws for oral chemotherapy, reports the American Cancer Society's Cancer Action Network.
However, proponents argue that a federal law is needed to achieve parity in all states; and to resolve the fact that private, self-funded plans that pay enrollees' claims directly typically aren't required to comply with state parity laws.
Given the high cost of these drugs—which can be six figures for one course—insurers warn that if they have to absorb the majority of the expense, premiums will have to increase to compensate.
"This legislation would place an arbitrary limit on cost-sharing between medical and pharmacy benefits, forcing premiums to increase for all consumers as a result," says Clare Krusing, press secretary at AHIP.