State Spotlight: Improving Access in Michigan
Dr. Philip Stella, a physician in the St. Joseph Health System, makes the case for legislation moving through the Michigan State Legislature that would improve access to oral chemotherapy treatments.
Remarkably, many insurance companies make it more expensive for patients to take a pill than going to the hospital for an intravenous treatment. Oral parity laws require insurance companies to provide equal coverage for both IV and pill treatments.
“Oral cancer drugs play an increasingly important role in my day-to-day care of cancer patients,” Dr. Stella writes in an opinion piece featured at the Detroit News. “Sometimes oral medications represent the only or best treatment option, making them a non-negotiable part of a thoughtful plan of care… Many patients are finding their health plans don’t cover oral chemo drugs in the same way they do more traditional methods of IV chemotherapy.”
SB 625 is common-sense legislation that will greatly benefit patients. (See Our Next Story.) If passed and signed into law, Michigan would become the 41st state to ensure equal policies for traditional intravenous cancer drugs and oral cancer drugs.
The Financial Burden of Cancer
For anyone questioning why oral parity laws are necessary, just read Reuters Health’s latest story on the financial burden of cancer. According to new research published by the journal, Cancer, almost a third of the 14 million American cancer survivors face financial burdens.
“We found that cancer survivors with three or more financial problems had clinically meaningful differences in their physical and mental health-related quality of life and were two to three times more likely to report depressed mood and six to eight times more likely to worry about cancer recurrence,” lead author Hrishikesh P. Kale of Virginia Commonwealth University in Richmond told Reuters Health.
Of course, cancer patients didn’t need a new study to confirm the stress and strain resulting from the financial burden of cancer. Perhaps the most devastating aspect of the financial burden is that newer and specialty treatments aren’t covered by insurance. Patients essentially are forced to choose between their best treatment and the most affordable treatment.
“Financial burden results from the high cost of cancer care,” says Norman V. Carroll of Virginia Commonwealth University, a senior author of the study. “This is especially true for the newer, biologically-derived specialty drugs,” which can require patient copays of several hundred dollars per month.
Zika: Got Funding?
“We are scraping together every dime we can,” Centers for Disease Control and Prevention (CDC) Director Tom Friedensaid in interviews last week. “It’s not easy to do that, and it makes the response much more complex and much less smooth.”
A top infectious disease expert told The Hill that “the development of at least three vaccines would have to slow down or stop without the funding.”
In Depth: Precision Medicine
Chitra Edwin, PhD, RAC provides a detailed primer on the state of precision medicine — current technology and regulations as well as the challenges facing precision medicine.
Despite what you may think, Dr. Edwin reminds us that precision medicine isn’t new at all. The practice dates back to the Classical and Hellenistic periods between the 5th century BC and the 2nd century AD, when it was created by the Greek physicians of the Hippocratic Corpus.
Back in modern times, the global market for precision medicine is expected to reach $2.5 billion by 2022.
Of the biggest challenges facing precision medicine: regulations and reimbursement. Dr. Edwin writes:
- On Regulations: “At the policy level, the extent of regulation necessary in the development of clinical products for PM to ensure patient protection and encourage innovation continues to be a challenge.”
- On Reimbursement: “Unfortunately, personalized medicine is not yet recourse to a vast proportion of insured, cancer patients who would benefit immensely from customized treatment.”