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Apr 13 2017

The Battle between Drug Makers & Insurers Over Chemotherapy

Cancer treatment is constantly changing and it leads to fighting from drug makers and insurers in regards to coverage and the price of chemotherapy.

Drug makers want to ensure patients receive the chemotherapy drugs, but insurers want to limit coverage or require a higher co-payment for certain treatments.

In a recent case in Arkansas, drug makers won a battle in regards to chemotherapy. The governor of the state determined that private insurance providers could not charge more for chemotherapy when taken orally rather than through an infusion at the medical facility. As a result, chemotherapy taken through a pill will be more affordable to cancer patients. Arkansas was the 43rd state to sign similar legislation in regards to chemotherapy and patient groups continue to push for other states to engage similar solutions in regards to insurance coverage.

The insurance providers want to set prices for different services, even when patients take the same medications in a different form. The recent legislation brought the battle between insurance providers and drug makers into the spotlight because it pointed out a problem within insurance coverage. While it is not yet clear whether the private insurance providers or the drug makers will win cases in the states without provisions in regards to chemotherapy, it is likely that the push for similar pricing and co-pay on chemotherapy will persist into other states.

For patients, the legislation is a bright area that makes it possible to seek treatment for cancer. It gives patients hope that they will not end up spending more on their treatments when they have options in relation to their medications.

Written by Amanda Roemer · Categorized: Insurance

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