[GUEST BLOGGER] Author Joni Aldrich Speaks Up for Oral Parity in NC

 

ImageOral chemotherapy parity should be simply that.  Chemotherapy is chemotherapy, whether it’s administered in the hospital/cancer center or at home–and thereby should be covered under major medical insurance instead of pharmacy benefits. Health insurance pharmaceutical coverage and the high cost of new oral chemotherapy drugs usually leave the cancer patient with large co-pays to pay out of pocket–thousands of dollars per month–leading to many patients having to decide between the best new treatment for their cancer or paying for food and shelter for their family. With medical expenses being the #1 cause of bankruptcy in the United States, this is definitely a major contributor.

Oral chemotherapy parity laws with a variety of formats have been passed in 25 states now, and there is a federal law in the works. In many of these states, the insurance companies have come out FOR the legislation. They realize that administering the meds at home instead of all of the costs related to hospital/chemo room IV’s, etc., is actually cheaper. This has been analyzed and proven to be true and more cost effective–to either save insurance companies money or cost very little extra. Some legislators (unbelievably) are trying to make oral chemo parity sound like cancer patients want a “free ride”. Really? Cancer patients just want to live–and not have to lose their home to do it.

Oral chemo is great for the patient, too, leading to less long-term side effects, a better quality of life, safer treatment (away from germs and viruses at the hospital), and taking a pill at home often enables the cancer patient to lead a more normal life–even allowing them to continue work.

In North Carolina, we are fighting for the North Carolina Cancer Treatment Fairness Act. It started as a focused Bill that would stay true to parity–oral chemo covered under major medical. Unfortunately, several insurance providers have come out AGAINST the legislation in North Carolina. At first they tried for a $500 cap; FOR EACH PRESCRIPTION. Well, the average mortgage in NC is $694 dollars, which means that $500 for each prescription is out of most people’s economic range–not to mention that the cancer patient is not usually on just one medication.

Somehow the necessary focus on oral chemo parity got lost in this co-pay issue, however, the Bill passed the House with a $300 co-pay cap (a little better) and an effective date in 2015. We really want to get it back to either true oral chemo parity with an effective date of 2014, or $100 co-pay cap with an effective date of 2014 when it goes to the NC Senate to be reviewed and hopefully passed.

To add to the confusion (which is being fueled mostly by BCBS of North Carolina), there is much talk about how this works with the Federal Health Care Bill. How many cancer patients will it really help? Smoke and mirrors…… To learn more, you can go to www.NCCancerAdvocacy.com.

 

Joni Aldrich is author of 6 books (on surviving cancer, caregiving, brain illness and grief), speaker, radio show host, and co-owner of www.W4CS.com, the world’s only 24/7 Cancer Support Network (free, no downloads or apps). She hosts 5 shows M-F at 2:00 p.m. EST: Cancer SOS, AdvocacyHealsU, Caregiving SOS, Treatment SOS, and Ladies Who Inspire. After losing her husband and mother to cancer, Joni has dedicated her life to helping cancer families through her work and advocacy efforts. To learn more go to: www.jonialdrich.com.

 

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