ATLANTA— The Georgia House of Representatives today passed House Bill 943, the Cancer Treatment Fairness Act. Sponsored by State Representative Lee Hawkins (R-Gainesville), HB 943 prevents cancer patients from paying higher out-of-pocket costs for oral medications than they would for medications administered intravenously.
“We need to give cancer patients affordable access to the most recently developed and most effective therapies, whether it is in oral or IV form,” said Rep. Hawkins. “Cancer is a devastating disease. Patients and their families face enormous challenges without having to worry about breaking the bank or having no access at all. HB 943 will provide an economical alternative.”
Under HB 943, insurance companies that cover intravenously administered chemotherapy must also cover orally administered chemotherapy as an equally favorable benefit, regardless of the benefit category determination. HB 943 also sets a limit of a $200 maximum out-of-pocket cost per filled prescription that an insured patient may pay for orally administered chemotherapy.
Recent studies have shown that the wholesale actual costs for many oral chemotherapy drugs are comparable to the same medication given by IV. However, patients typically spend more out-of-pocket costs for those medicines administered orally. This disparity exists because of an insurance industry practice that places IV anticancer treatments under a plan’s medical benefit and oral anticancer therapies under the pharmacy benefit. Additionally, pharmacy benefits often require the patient to pay a percentage of the total cost of the drug, while many medical insurance plans require the patient to pay a co-pay only.
For more information about HB 943, click here.
Representative Lee Hawkins represents the citizens of District 27, which includes portions of Hall and White counties. He was elected into the House of Representatives in 2012, and currently serves on the House Appropriations Subcommittee on Health and the Health & Human Services, Insurance, and Retirement committees.
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