Should Insurance Companies Cover Cost Of Oral Cancer Treatments?

LANSING (WWJ) – Lawmakers in Lansing Tuesday will debate whether insurance companies should cover oral cancer treatment drugs.

As it stands now, insurance companies require a co-pay for the pills, which can run patients several thousand dollars a month, according to Karmanos Cancer CEO Gerold Bepler.

Bepler said that’s a problem, because the drugs are extremely effective for a select group of cancer patients.

“It’s like a miracle. You start the drug and two weeks, three weeks, maybe four weeks later, you cannot detect the cancer anymore. So, as a result, the patient can go about their lives totally normally, they can go to work, they’re not violently sick as patients often are when they get intravenous chemotherapy. So, it’s a true advance.”

Those who oppose covering the drugs worry about higher insurance premiums, but Bepler said premiums have not gone up in states that have already made insurance companies cover the treatment.

“Obviously, if this is the drug of choice for a patient and the insurance requires a 25 or 30 percent co-pay, and suddenly the patient has to pay between $2,500 and $3,000 a month for an oral medication that’s suddenly totally different.”

Insurers oppose the measure, arguing that oral treatments are more expensive than intravenous chemotherapy. Insurers also say a coverage mandate could raise insurance costs for everyone.


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