Healthcare

Cancer ‘parity’ bills churn through Florida Legislature

 

Bills in the Florida Legislature would compel health insurers to cover cancer pills the same way they cover intravenous or injectable chemotherapy.

 

Luke Webb sits in his office at Export Ski and Wake Marine. A few months after he married at age 28, Luke Webb was diagnosed with leukemia. Webb pays about $7,000 a month for a 30-day supply of the oral chemotherapy, and it isn't covered by his private insurance.
Luke Webb sits in his office at Export Ski and Wake Marine. A few months after he married at age 28, Luke Webb was diagnosed with leukemia. Webb pays about $7,000 a month for a 30-day supply of the oral chemotherapy, and it isn't covered by his private insurance.
MICHELLE KANAAR / MIAMI HERALD STAFF

dchang@MiamiHerald.com

Without his chemotherapy pills, Luke Webb might not be alive today.

With the medication — a pill named Sprycel that targets cancer cells only, and does not leave patients weak and nauseated like radiation or chemotherapy — Webb said he leads a normal life four years after being diagnosed with chronic myelogenous leukemia, a deadly blood cancer.

He experiences few if any side effects from the pills, Webb said. He leads an active lifestyle, and is planning to start a family with his wife, Molly, whom he married a few months before receiving his cancer diagnosis.

“It’s gone from literally thinking I was going to die, and reading all this stuff on the Internet and everything else, to living a perfectly normal life,’’ he said of the pills. “It’s changed my life.

But there is an unintended consequence to his medication: Webb says he was forced to give up his career as a business development officer, and take a lower-paying job in the marine industry so he could qualify to receive the pricey pills without cost to him, through a financial assistance program from the pharmaceutical manufacturer, Bristol-Myers Squibb.

It’s a trade that Webb, 32, said he accepts in exchange for “a normal life.”

“To get there,’’ he said, “I’ve had to take a much lower-paying job.’’

Families must earn less than $30,000 a year to be eligible for the financial assistance program

Webb estimates Sprycel would cost him about $7,300 for a 30-day supply without the assistance.

He has health insurance, and the plan covers chemotherapy medication — but only when the medicine is administered intravenously or by injection. Because Webb’s medication is only available in pill form, his insurer considers the drug a pharmaceutical benefit and will not cover the cost.

Florida legislators call this disparity unfair, and many have lined up behind proposed bills in the House and Senate called The Cancer Treatment Fairness Act, which would require private insurers to cover oral chemotherapy the same way they cover intravenous or injection chemotherapy.

“It is such a widespread problem, and it is time,’’ said Senate Majority Leader Lizbeth Benacquisto, R-Fort Myers, sponsor of the Senate bill.

“It’s time for us to change the way we’re paying for cancer treatment, and get with the program,’’ added Rep. Debbie Mayfield, R-Vero Beach, who sponsored the bill in the House.

State senators unanimously approved the bill on April 4. In the House, the bill is scheduled for a hearing Tuesday in the Health and Human Services Committee before it can be put to a vote on the floor.

Though similar versions of the bill stalled in the House and Senate during the last two legislative sessions, Benacquisto and Mayfield said the legislation enjoys broad support among leadership in both chambers — with 24 co-sponsors in the Senate, and 79 co-sponsors in the House.

“This is a bill everyone really does agree on,’’ said Mayfield, whose husband, Stan, died of gastroesophageal cancer in 2008.

Health plan representatives, however, have expressed concerns that the bill may conflict with the federal Patient Protection and Affordable Care Act, potentially driving up the costs of health insurance plans for patients.

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