Breaking News
January 22, 2018 - Mallinckrodt Completes Stannsoporfin New Drug Application Filing
January 22, 2018 - ACOG Backs ‘Cascade Testing’ for Cancer-Related Mutations
January 22, 2018 - The terrible toll tennis can take on top players who play too much
January 22, 2018 - KAIST scientists identify cellular mechanism for severe viral hepatitis
January 22, 2018 - New genomic tools provide better understanding of the human immune system
January 22, 2018 - Improving QoL with an App?
January 22, 2018 - First step toward CRISPR cure of Lou Gehrig’s disease
January 22, 2018 - Scientists uncover the proteins responsible for movement
January 22, 2018 - New clinical practice guideline provides recommendations for use of anticoagulants during heart surgery
January 22, 2018 - Depressive symptoms associated with poorer survival in patients with head and neck cancer
January 22, 2018 - Restaurant Bans Have Big Impact on Smoking Rates
January 22, 2018 - D.C. Week: CMS Outlines Path for Medicaid Work Mandate
January 22, 2018 - Study identifies new loci associated with asthma enriched in epigenetic marks
January 22, 2018 - New bug may reduce misery of hay fever sufferers
January 22, 2018 - Specially prepared supplement helps women to run faster, study shows
January 22, 2018 - 3-D Stent Retriever with Aspiration Proves Mettle in AIS
January 22, 2018 - Public health research seeks to understand how natural disasters impact spread of Zika
January 22, 2018 - Research reveals role of nanophenomenon in stimulating bone-repair process
January 22, 2018 - Drinking during late adolescence could be first step to liver problems in adulthood
January 22, 2018 - Epilepsy associated with volume and thickness differences in brain matter
January 22, 2018 - Trevena Announces FDA Acceptance for Review of New Drug Application for Olinvo (oliceridine) Injection
January 22, 2018 - A Noteworthy Margin of Error
January 22, 2018 - Firm advances human trials of revolutionary vaccine
January 22, 2018 - Many Indians put away treating orthopedic problems
January 22, 2018 - Cherwell releases new pocket guide to prepared culture media
January 22, 2018 - Huron earns ISO 13485 certification for quality management system
January 22, 2018 - Avion Pharmaceuticals Announces FDA Approval of Balcoltra (levonorgestrel and ethinyl estradiol tablets and ferrous bisglycinate tablets) Oral Contraceptive
January 22, 2018 - Multi-Gene Test For Early CVD; Neighborhood HF Risk; Novel Testosterone Drugs
January 22, 2018 - Skipping breakfast disrupts ‘clock genes’ that regulate body weight
January 22, 2018 - Creativity May Rely on ‘Teamwork’ in the Brain
January 22, 2018 - NeuroBreak: Alzheimer’s Germ Contest; High Salt Diet May Be Bad for Brain
January 22, 2018 - Diabetics may often fare poorly in hospice care
January 22, 2018 - Performance enhancing benefits of caffeine more apparent for infrequent tea, coffee drinkers
January 22, 2018 - HHS Unveils Framework for Interoperability
January 22, 2018 - More dentists to discuss risks of HPV-related cancers with their patients
January 21, 2018 - Research shows how Zika virus damages placenta to cause malformations in babies
January 21, 2018 - Achaogen Announces FDA Acceptance of New Drug Application with Priority Review for Plazomicin for Treatment of Complicated Urinary Tract Infections and Bloodstream Infections
January 21, 2018 - Drug Allergies: Time to Re-Test?
January 21, 2018 - Mitochondrial protein in cardiac muscle cells linked to heart failure, study finds
January 21, 2018 - Women more likely than men to die from a heart attack
January 21, 2018 - Next generation genomic sequencing can help detect pathogens after joint replacement
January 21, 2018 - Gov’t Shutdown Looms as Senate Debates Spending Bill
January 21, 2018 - Emergency Readiness for Older Adults and People with Disabilities
January 21, 2018 - Heart health at risk for Latinas over worries about deportation
January 21, 2018 - Scientists methodically identify genes related to blood feeding and non-biting mosquitoes
January 21, 2018 - Researchers discover potential target genes to halt thyroid cancer progression
January 21, 2018 - Youth with shared residency after parents’ divorce have less mental issues
January 21, 2018 - Sleep Better, Lose Weight? – Drugs.com MedNews
January 21, 2018 - More $$ Needed for Health Emergencies, Senators Told
January 21, 2018 - Gene test to predict breast cancer recurrence less cost effective in real world practice
January 21, 2018 - Study finds rise in number of adolescents receiving psychiatric or neurodevelopmental diagnosis
January 21, 2018 - Reminders can improve immunization rates
January 21, 2018 - A More Personalized Approach to PSA Screening in 2017
January 21, 2018 - T-cells engineered to outsmart tumors induce clinical responses in relapsed Hodgkin lymphoma
January 21, 2018 - Tetraphase Pharmaceuticals Announces Submission of New Drug Application to FDA for Eravacycline for the Treatment of Complicated Intra-Abdominal Infections (cIAI)
January 21, 2018 - Have Robotics Had a Detrimental Effect on Surgical Residency?
January 21, 2018 - Being bilingual may help autistic children
January 21, 2018 - Metrics Are Not Widespread in Rheumatoid Care
January 21, 2018 - Neuroanatomic abnormalities ID’d in those at risk for autism
January 21, 2018 - Children born with Down’s syndrome have superior genome that compensates for disability
January 21, 2018 - Study finds higher risks for asymptomatic paroxysmal AF patients
January 21, 2018 - The Second Stage of Diet Resolutions
January 21, 2018 - CT Scans Reduce Lung Cancer Deaths … But Among Whom?
January 21, 2018 - ADHD drug use soars among young women
January 21, 2018 - Researchers propose new regulation mechanism linked to action of SirT6 on chromatin
January 21, 2018 - Statins appear to reduce risk of repeated surgery in patients who undergo vitrectomy
January 21, 2018 - Morning Break: Hep A Outbreak Spreads; Tide Pod Challenge; Keeping Lobsters Out of Hot Water
January 21, 2018 - EULAR and ACR present SLE classification criteria at the 2017 ACR/ARHP Annual Meeting
January 21, 2018 - Progenics Pharmaceuticals Announces FDA Acceptance of New Drug Application for Azedra (iobenguane I 131) in Pheochromocytoma and Paraganglioma
January 21, 2018 - House Passes Funding Bill with 6-Year CHIP Renewal
January 21, 2018 - DASH ranked Best Diet Overall for eighth year in a row by U.S. News and World Report
January 21, 2018 - Dementia study sheds light on how damage spreads through brain
January 20, 2018 - Morning Break: Missing Maria Deaths; N.J. Doc Charged in Wife’s Murder; Viva Vaseline!
January 20, 2018 - No interventions proven to prevent late-life dementia
January 20, 2018 - Judge orders new Olympus trial over superbug death
January 20, 2018 - Don’t Rely on Just One Blood Pressure Test for Kids: Study
January 20, 2018 - Going Off the Deep End About Water
January 20, 2018 - Parental attention can reduce risk of drug abuse in adolescence
January 20, 2018 - Mast Uri System offers efficient and cost-friendly diagnostic solution
January 20, 2018 - International SOS, Chatham House sign partnership agreement to further advance Global Health Security Agenda
Laws to equalize cancer patients’ out-of-pocket costs provide uneven protection

Laws to equalize cancer patients’ out-of-pocket costs provide uneven protection

image_pdfDownload PDFimage_print

Laws passed by many states that require health plans to charge the same cost-sharing amounts for cancer patients receiving chemotherapy — regardless of whether they get the medication intravenously or take a pill or liquid by mouth — are providing uneven pocketbook protection, according to a new study.

These “parity” laws became popular as the number of pricey anti-cancer oral medications grew, but consumers were seeing a disparity in how insurance handled the patients’ share of the treatment.

In many plans, oral anti-cancer drugs were placed in high cost-sharing tiers in patients’ prescription coverage while the drug infusions — which took place at a doctor’s office — were handled as an office visit and generally required less out-of-pocket costs for patients, sometimes just a minimal copayment.

The study, published online in JAMA Oncology this week, analyzed the health plan claims of 63,780 adult cancer patients younger than age 65. All lived in states that passed parity laws from 2008 to 2012.

State parity laws don’t apply to “self-funded” employer health plans that pay their workers’ claims directly rather than buying state-regulated insurance policies. Just under half of the patients studied were covered by self-funded plans. Researchers compared the use of oral anti-cancer medicines and out-of-pocket spending between patients in the self-funded plans and those in state-regulated plans to determine the impact of parity laws.

The study found that the laws benefited those with lower monthly out-of-pocket spending more than those whose monthly spending for oral chemotherapy drugs was higher. According to the research, the proportion of prescriptions for oral drugs that did not require a patient’s copayment grew from 15 to 53 percent over the study period in health plans that were subject to state parity laws. That was more than double the increase in plans that were not subject to parity laws, which increased from 12.3 to 18 percent.

The finding surprised researchers, said Stacie Dusetzina, an assistant professor of pharmacy and public health at the University of North Carolina-Chapel Hill, who was the study’s lead author.

At the other end of the spectrum, the number of prescriptions requiring high out-of-pocket spending grew, despite parity laws. The proportion of prescriptions filled in plans subject to parity that cost more than $100 out-of-pocket per month increased from 8.4 to 11.1 percent, the study found. That figure declined slightly for prescriptions in plans that weren’t subject to parity, from 12 to 11.7 percent.

“We are a bit concerned about that finding, because when you think about who would have been the target of the law, parity is intended to help people afford the cost of their treatment,” Dusetzina said. “The most expensive fills got more expensive after parity. That’s concerning.”

The researchers suggested that continuing growth in high-deductible plans and high coinsurance charges may have contributed to the rise in the number of patients with high out-of-pocket costs for cancer treatment, even in states that have parity laws.

The study also found that out-of-pocket spending on infused drugs, which are typically older and less expensive than oral anti-cancer therapies, remained stable during the study period and was unaffected by parity laws.

A federal law that would extend parity to the seven states that don’t have it has been proposed in the past, most recently in March. Such a law could also benefit people in self-funded plans that aren’t subject to state laws, as well as Medicare beneficiaries.

“A federal law would potentially provide a lot of benefit, because we do feel parity has a net benefit for patients,” Dusetzina said.

Please visit khn.org/columnists to send comments or ideas for future topics for the Insuring Your Health column.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles