CHI Applauds Senate Passage of AB 219, a Cost-Savings Bill for Chemotherapy Drugs

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Bill gives patients more affordable access to orally-administered chemotherapy drugs.

As a cancer patient currently fighting Stage IV colon cancer, I know firsthand how devastating the costs of chemotherapy can be, said Eve Bukowski.

Today, a bill that would limit patient out-of-pocket costs for oral chemotherapy drugs passed out of the California State Senate 28-9 and is headed back to the Assembly for concurrence.

Assembly Bill AB 219, authored by Assembly Member Henry Perea (D-Fresno), would prohibit health care service plans and health insurance policies from requiring an enrollee or insured to pay a total cost-sharing amount of more than $200 per 30-day supply of orally administered anti-cancer medications.

Advances in orally administered anti-cancer medications have increased the range of available options to avoid chemotherapy administration in a doctor’s office. However, health care service plans and insurance policies may not cover these treatment options at the same level as inpatient care. “The current law does not limit out-of-pocket patient costs for chemotherapy drugs, leading to expenses upward of thousands of dollars,” said Eve Bukowski, vice president, state government affairs for the California Healthcare Institute (CHI).

When a patient is administered chemotherapy in the doctor’s office, they are required to pay a co-payment for the visit, but not a separate co-payment for the chemotherapy product itself. However, orally-administered cancer drugs are subject to extraordinary co-payment schedules on most health care service plans and insurance policies. For a $10,000 per month oral anticancer medication, this could mean more than $2,800 per month out-of-pocket for a patient. “As a cancer patient currently fighting Stage IV colon cancer, I know firsthand how devastating the costs of chemotherapy can be. AB 219 will help curb these costs and help advance patient care outside of the doctor’s office,” said Eve Bukowski.

Oral chemotherapy products can be more convenient for patients, who are able to avoid personal costs associated with traveling to a doctor’s office or infusion center, losing time at work, and child care costs among others. Also, the patient would not incur costs associated with chemotherapy administration in a doctor’s office relating to equipment, staff and capital. In addition, AB 219 could have a significant impact on women’s health. As the California Health Benefits Review Program (CHBRP) analysis notes, approximately 70 percent of the prescriptions for oral chemotherapy products are for breast cancer.

CHI applauds the passage of this bill out of the Senate and encourages the Assembly to swiftly concur and send AB 219 to the governor’s office.

About CHI
California Healthcare Institute (CHI) represents more than 275 leading biotechnology, medical device, diagnostics and pharmaceutical companies, and public and private academic biomedical research organizations. CHI’s mission is to advance responsible public policies that foster medical innovation and promote scientific discovery. To learn more, visit our website and follow us on Twitter @calhealthcare, Facebook, LinkedIn and YouTube.

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Erica Hiar
California Healthcare Institute
(202) 974-6322
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