A cancer diagnosis is one of the most disrupting and frightening experiences a person can go through. I know because it happened to me just last year.
I live with two forms of blood cancer – myelodysplastic syndrome and myelofibrosis. I am also one of the fortunate ones. Ongoing treatment has so far been successful in keeping the cancer in check, but I live with the reality that my body will stop responding so positively and I will need a new treatment game plan.
And unless the North Carolina Senate acts this week on legislation bringing fairness to cancer health coverage, I will also continue living with the reality that I might not be able to afford the next treatment I need, even though I have health insurance.
For many years, intravenous (IV) delivery was the primary method for administering the medicines used to treat cancer, but these days, many of the frontline cancer treatments are in pill form – used in conjunction with injectable or IV therapies, or even in place of them.
In fact, well over one-third of the anti-cancer medications approved by the Food & Drug Administration over the last two years are in pill form. For many cancers, the most effective and appropriate form of treatment comes in a pill, and for some cancers, such as chronic myeloid leukemia, an oral therapy is the only available treatment option.
Despite the need for oral anti-cancer medications, some health plans in North Carolina require patients to pay a large sum for them, often in the thousands of dollars, as opposed to the more reasonable fixed copay charge for IV treatments. The high costs make it difficult and often impossible for cancer patients to get the therapies their doctors prescribe. Without those prescribed therapies the prospects for continued life are extremely limited.
The sobering reality is that cancer is the leading cause of death in our state, with nearly 57,000 North Carolinians diagnosed each year. And yet, North Carolina is one of only seven states that hasn’t enacted legislation requiring health insurers to cover oral anti-cancer medications in the same way they cover injectable or IV chemotherapy.
The state House passed such legislation – known as the Cancer Treatment Fairness Act (HB 206) – this year and during the past two legislative sessions, yet it has never gotten a hearing in the Senate.
With the clock ticking down on this year’s session, time is of the essence for the Cancer Treatment Fairness Act and for the many North Carolinians that it would help. I hope senators will finally listen to our voices and allow the legislation to move forward.
Health insurance is a pool we all pay into so that we can afford care if or when we need it. No North Carolinian should have to forego the necessary treatment prescribed by their doctor because insurers do not cover oral anti-cancer medications in a fair way. It’s time to bring insurance policies in line with modern medicine – and in line with the rest of the country – and make cancer care fair in North Carolina.
Stuart Bethune is a patient advocate with the Leukemia & Lymphoma Society. He lives in Edenton and Chapel Hill.