Cancer Covered Blog

Oral Chemotherapy Bill

Presently, the state Senate is considering passing the bill on oral chemotherapy.

The state Assembly last week passed the bill which would cap the amount of co-payment at $100 per month for the cost of oral chemotherapy. Currently, there is a very large disparity in the coverage for intravenous versus oral chemotherapy. The payments for some patients may exceed $3,000 per month for all oral chemotherapy as opposed to only $150 for intravenous chemotherapy.

There are a variety of newer oral chemotherapy agents available in the last ten years which are very active and are the preferred agents for the treatment of certain malignancies. An example is in the treatment for chronic myelogenous leukemia or CML – one of the cancers of the blood. The disease can usually is diagnosed in people in their 50s and 60s but occasionally can be discovered as young as the early 20s. It is characterized as elevated blood counts. It was uniformly fatal with life expectancies of only 3-4 years once diagnosed. The initial effective treatment was a bone marrow transplant which required a donor. A bone marrow transplant can be complicated and is a very difficult procedure for some patients due to their other medical problems and age. Through intensive research, a unique chromosome translocation called the Philadelphia chromosome was discovered and found to be the cause of CML.

Medications have been developed which can block the abnormal protein which the Philadelphia chromosome produces and can halt the growth of the abnormal cells. The first of these medications developed is called imatinib. This drug, when used in CML, can completely halt the growth of the CML cells and prolong a patient’s life. Unfortunately, it appears that imatinib will need to be continued for the rest of the patient’s life. Taking the pill form can be a more convenient process for patients vs having traditional infusion chemotherapy. When patients are taking imatinib, their lives can return to normal with limited side-effects and their life-expectancy can return to normal versus only 3-4 years without imatinib. The cost for oral imatinib is approximately $9,000 per month or $108,000 per year.  By passing the proposed bill, patients would be subject to markedly less costs subject to deductible, out-of-pocket maximums and a $100 per month copayment only.

As the above illustrates, it is imperative that the state legislature and our governor work diligently on passing legislation that will help bring the cost of these medications down for people of Wisconsin.

Dr. Tony Jaslowski signature
Anthony Jaslowski, MD, FACP

Tony is very focused on patient understanding and has a wonderful ability to simplify even the most complex information.

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