Opinion

Equality in anti-cancer treatment needed now

A young cancer patient stares out a hospital window. (Photo: Solid photos, via Shutterstock)

In the many years we have been treating patients, the hardest conversations to get through were always revealing a person’s cancer diagnosis to them for the first time.

 But like everything else in our world today—that has changed because of the COVID-19 pandemic.  Now, the difficult conversations doctors are having with patients focus on how they can safely manage their cancer treatment and minimize the risk of contracting this new deadly disease.

There is a viable solution that lawmakers in Washington should consider to help eliminate unnecessary risk to patients.

Many cancer patients regularly go to infusion centers for several hours, multiple times a month to receive intravenous treatment.  On a normal day, being in public, while undergoing treatment can pose a risk to patients undergoing chemotherapy, as their immune systems are weakened as a result of their treatments.

Today, with the increased risk of contracting COVID-19,  leaving home for treatment has become a much more dangerous proposition.

Where we can safely alleviate this burden, we must.  That is why our organization, and more than 30 others who represent leaders throughout the cancer community, are calling on lawmakers to take action to make sure as many cancer patients as possible have access when medically appropriate to home treatment options, in the form of anti-cancer pills to treat their disease.

It is the right thing to do for those living with cancer and for the greater good of the health care system at large.

As we know, delaying cancer treatment can often lead to worsening of the disease. If patients have an oral chemotherapy option, the risk of them contracting COVID-19 is lessened, but we also won’t lose valuable time in treating their cancer while maintaining physical distancing.

This makes perfect sense until you factor in one thing—the still existing, outdated policies of some insurance companies who don’t cover IV chemotherapy treatment and oral chemotherapy treatments in the same way.

Some insurance plans categorize the two types of treatment differently—the IV infusions are considered a medical benefit, and patients might have a small co-pay like when you go to the doctor, or often none at all.  But oral anti-cancer treatments are categorized under some patients’ prescription drug programs, meaning the insurer can pass on large co-pays to the patient, often leading to out of pocket costs patients can’t bear.

This is a problem we see regularly, and often have to tailor care to what we know the patient will be able to afford.  But now, in an environment where people are financially insecure due to millions of job losses,  as well as the added worry of the Coronavirus, lawmakers must act swiftly to bring equality to all cancer treatments, by passing legislation that will ensure that patients will have similar out of pocket cost sharing whether  they need  infused treatments or an oral medication  they can safely take at home.

Doing so will give doctors more leeway, when medically appropriate, to transition patients onto oral (or self-administered) chemotherapy drugs to manage their disease.

Similar laws have been passed in more than 40 states that offer this equality in treatment options for patients.  But, without these protections in federal law, patients who have insurance regulated at the federal level may face an unfair decision—whether to risk skipping treatment or to risk contracting COVID-19.

That is not a choice that should have to be considered.   And the passage of oral chemotherapy parity legislation will eliminate this heartbreaking choice for patients in today’s environment and going forward.  In the best of times, patients undergoing chemotherapy are immunocompromised and are at risk leaving the safety of home to go to an infusion clinic.

We know that not every cancer can be treated with an oral medication, and we know that this is not a solution that will work for everyone.  But it can save lives and help to continue to flatten the curve. It is the right thing to do for those living with cancer and for the greater good of the health care system at large.

This problem is one that will not be going away quickly, and as predicted by some health care leaders could continue to emerge with smaller, similar outbreaks in the months and years to come.

We urge Washington to move quickly to bring equal coverage to all available anti-cancer treatments in the next COVID-19 relief package.

Ed’s Note: Dr. Brian Durie is Chairman of the Board of the International Myeloma Foundation and Dr. Joseph Mikhael is Chief Medical Officer of International Myeloma Foundation located Southern California.


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