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Wisconsin bill seeks equal chemotherapy coverage

  • Associated Press
  • January 24, 2014 - 12:00 PM

FOND DU LAC, Wis. — Some Wisconsin cancer patients are being forced to choose between oral chemotherapy that could be the most effective treatment and traditional chemotherapy covered by their insurance.

So some lawmakers and advocacy groups want to require health plans to cover treatments equally for intravenous and oral therapies, according to The Reporter Media (http://fondul.ac/1d0IUoE ).

Wisconsin Coalition for Cancer Treatment Access is working with state Rep. Jeremy Thiesfeldt, R-Fond du Lac, on a bill that has already received bipartisan backing from 57 legislators. The Senate Insurance Committee voted unanimously Wednesday to support the bill. It's expected to come up for a vote in the Senate and Assembly.

According to the coalition, the bill is not a mandate because it does not require that a treatment be covered by insurers. Rather, it would ensure that cancer patients have access to oral chemotherapy products if traditional chemotherapies are covered by their insurance plan.

Historically, intravenous treatments have been the predominant route for administering anticancer drug therapy. While oral therapies have been available for decades, more than 25 percent of the 400 chemotherapy drugs in the development pipeline are now oral therapies.

These pills are less toxic than conventional IV chemotherapy, and have turned once-incurable cancers, such as myeloma and breast cancer, into manageable diseases.

Dick Skalitzky, 57, of Fond Du Lac, was diagnosed with multiple myeloma in 2009. It's most effectively treated with a combination of oral cancer/chemotherapy pills but it costs him $8,000 per month.

"Before this pill came out in 2005, myeloma patients did not have much hope," Skalitzky said. "With pills there are fewer side effects, I can continue working and there is a better quality of life."

Skalitzky was one of the advocates who met with Thiesfeldt early last year on the bill. Thiesfeldt believes that requiring insurance companies to fund chemotherapy treatments the same way benefits families and enhances quality of life.

State Sen. Rick Gudex, R-Fond du Lac, said he intends to support the bill, but needs more information on how it may impact the Affordable Care Act and health plan designs. In the 27 states that have already passed this law, there's no evidence that it increased health insurance premiums, Gudex said.

© 2014 Star Tribune