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FORCE advocates for families facing hereditary breast and ovarian cancer in areas such as access to care, research funding, insurance, and privacy.

Advocacy > Issues > FORCE Supports Oral Chemotherapy Parity Initiatives

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Newsflash

2/7/2018
FORCE staff and advocates joined stakeholders for a "BRCA Community Perspectives on Data Sharing" workshop in Santa Cruz, CA.

2/6/2018
We joined nearly 40 patient and health care professional organizations in expressing opposition to proposed national right-to-try legislation. Read the letter...

1/17/2018
FORCE submitted comments on a draft CMS Policy on NGS for Medicare Beneficiaries with Advanced Cancer.

1/3/2018
PALS Act moratorium extended to January 2019, preserving insurance coverage of mammograms for women ages 40-49. Read more...

12/20/2018
Court vacates EEOC wellness program rules effective January 1, 2019 signaling end to coercive practices.

FORCE Supports Oral Chemotherapy Parity Initiatives

Insurance Coverage & Barriers

Overview

Oral chemotherapy is becoming more common and is the standard of care for many types of cancer. Oral treatment also accounts for about a third of the oncology development pipeline. Importantly, many oral anti-cancer medications do not have IV or injected alternatives, and are the only option for some patients. PARP inhibitors, which hold great promise for treating BRCA-related cancers, are just one example. For this reason, these medications must be as affordable as their IV counterparts. FORCE is supporting the Cancer Drug Coverage Parity Act of 2017, a national legislative initiative which strives to create equal insurance coverage of patient administered and physician administered cancer treatments.

The Cancer Drug Coverage Parity Act of 2017 requires any private health plan that provides coverage for cancer chemotherapy treatment to also cover anticancer regimens regardless of delivery method, including oral, self-administered anticancer medication at a cost similar to that of IV, port administered, or injected anticancer medications. Patients who receive intravenously administered therapies, covered under an insurance plan's medical benefit, are responsible only for a copayment for each office visit. Conversely, oral chemotherapy is typically covered under an insurer's pharmacy benefit, resulting in substantially higher out-of-pocket costs and a significant financial burden for many patients. 

Oral anticancer drugs have become the standard of care for several types of cancer in recent years.   Many of these new oral therapies target specific biologic processes in cancer cells and block cancer cell growth. In addition to their specificity, which can result in reduced toxicity and side effects, oral agents are convenient—especially for patients who travel long distances to their treatment facility.

Outdated insurance coverage policies have not kept pace with medical innovation and the growing trend toward orally administered chemotherapy. FORCE believes that every cancer patient should have access to the anticancer regimen recommended by their health care team, and should not be subject to cost discrimination based on the delivery mechanism of the therapy.

FORCE is a member of the Patients Equal Access Coalition (PEAC), supporting state-level efforts to address this issue in addition to the national legislative initiative.

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