The Colorado House killed a bill today that would have required Colorado health insurance companies to cover oral chemotherapy pills. Diane Primavera (D-Broomfield), sponsored Senate Bill 250 in the House, and had support from patient advocate groups and the pharmaceutical industry. But the House Health and Human Services Committee voted 7 – 4 to kill the bill.
Money was a major factor, on both sides. People like Primavera (herself a cancer survivor) and the patient advocate groups were likely working with patients’ best interests in mind. But my guess is that the pharmaceutical industry wanted this bill to pass because they would like the extra revenue that would be generated if all the health insurance carriers in Colorado had to start covering oral chemotherapy. Estimates from Kaiser Permanente of Colorado pegged the cost of oral chemotherapy at more than nine times the cost of using intravenous chemotherapy. That would seem like a very good motivator for pharmaceutical companies to get involved.
Of course, those numbers also reflect the reason the bill was killed. There’s no way that this bill would have passed without premium increases going along with it. One lawmaker estimated that it would have increased premiums by $147/month for every insured family in Colorado.
Proponents of the bill noted that oral chemotherapy is much less intrusive for a patient: the person can continue to go to work and lead a somewhat normal life, taking medicine at home rather than going to a hospital or clinic for chemotherapy treatment. For my own family, at-home dialysis has made my father’s life much easier than it was when he had to go to a dialysis clinic three times a week. So I do understand the desire to be able to take a pill rather than go to a cancer center for treatment. But while dialysis can go on for years (my dad has been on dialysis for nearly eight years), chemotherapy is a relatively short-term treatment. I’m sure that people going through chemotherapy would much rather have a more convenient method of getting their treatment, but at nine times the cost, it doesn’t seem that oral chemotherapy would make much financial sense.
Of couse, if there’s a difference in patient survival and overall outcomes, that would be a different story. But if all we’re looking at is cost and ease of use, I have to say that I agree with the vote in the House committee today. A measure that would significantly increase health insurance premiums for Colorado residents doesn’t seem like a good idea, especially when there’s a less expensive alternative (intravenous chemo) to the chemotherapy pills.