There is an enormous financial burden placed on cancer patients in Pennsylvania due to an antiquated insurance provision — IV medications are considered a medical benefit, and therefore the cost is limited to co-pays, which are usually only $20 to $30 a session.
On the other hand, oral chemotherapy pills are considered a pharmacy benefit, requiring the patient to pay a percentage of the cost of the pills.
Several years ago, I was diagnosed with chronic myelogenous leukemia. At one time, the only cure was a complete bone marrow transplant. Thanks to research, oral chemotherapy drugs have been approved for treatment. Today, half of all Food and Drug Administration-approved oncological treatments are oral medications.
My doctor initially prescribed Gleevec, which has an 89 percent, five-year survival rate. In my case, even with 80 percent of the costs of my medicine covered by my insurance, I had a monthly expense of $1,100.
On the bright side, I was able to take the pills at home, go to my job as a teacher’s assistant and still take my boys to football practice. I later learned that Gleevec was no longer working and the cancer in my blood was increasing. I switched to a new chemotherapy medicine called Sprycel, which costs $1,590 per month for me.
Taking this pill is keeping me alive — I just wish I did not have to pay so dearly for it.
As cancer patients, we should be able to make our health care decisions based on the most effective treatment for our diagnosis and lifestyle, not an insurance technicality that can put the best option out of reach.
Pennsylvania lags behind 34 other states that have passed legislation to fix this disparity. I encourage Pennsylvania’s elected leaders to act now to prevent one more story like mine.