Bill to make orally administered cancer treatments more affordable passes Pa. House

HARRISBURG, Feb. 24 – State Rep. Chris Sainato has voted for a bill that would put the cost of orally administered chemotherapy treatments within reach of more Pennsylvanians.  


The bill (H.B. 60) passed the state House today 197-3.


"Pennsylvanians fighting for their lives should have affordable access to chemotherapy," said Sainato, D-Beaver/Lawrence. "It should not matter if the treatment recommended by a doctor is ingested or injected."


Intravenous chemotherapy treatments are usually covered under a health plan's medical benefit and require a minimal payment. Orally administered treatments are covered under a health plan's pharmacy benefit. Some insurance companies have placed orally administered treatments on "specialty tiers," requiring those who need the drugs to pay as much as one-third of the cost.


Typically, a person will pay $1,500 to $3,000 per prescription for a specialty tier drug, according to a study by the Pennsylvania Legislative Budget and Finance Committee. Sainato said the median annual household income in Pennsylvania is $50,000, so the course of treatment would be unaffordable to many residents.


House Bill 60 would prohibit insurance companies from placing oral anti-cancer medications on a specialty tier or charging a co-insurance payment for the medication.


Sainato noted that the LBFC study found that more than 30 percent of people who were prescribed a drug on a specialty tier did not take it, and almost 40 percent said they took on additional credit card debt and had difficulty buying groceries.


According to the study, 90 percent of Medicare Part D prescription plans use specialty tiers, and 23 percent of employer health benefit plans have these tiers.


The bill now goes to the state Senate for consideration. If it passes that chamber and is signed into law, Pennsylvania will join at least 34 other states that have enacted oral chemotherapy access laws.