BOISE, Idaho –– More Idaho cancer patients will have easier and more affordable access to oral chemotherapy drugs thanks to House Bill 648, passed by the Idaho Legislature and signed into law this session by Gov. Brad Little.
The bill requires state-regulated health insurance plans to equalize out-of-pocket costs between oral, self-administered anti-cancer medications and other forms, such as intravenous (IV), injected or port-administered therapies. Because oral chemotherapy drugs exist in pill form, they are typically covered under a health plan's pharmacy benefit, and not under the health plan's medical benefit, as is the case with IV chemo.
This can result in a significant cost increase because, under the pharmacy benefit, oral chemotherapy medications are often classified in the highest tier of a health plan's cost-sharing system requiring patients to pay higher co-payments, which can sometimes be a percentage of the drug’s cost, potentially resulting in thousands of dollars in out-of-pocket costs each month. This disparity between drug delivery can restrict access to life-saving oral cancer therapies. Oral chemotherapy may be the best option for the patient, but the higher cost compared to IV creates an unfair disparity that prevents saving lives.
Rep. Chris Bruce (R-Kuna) sponsored the bill, which will take effect July 1. Oral chemotherapy fairness bills have run unsuccessfully in the Idaho Legislature several times prior to this session.
“I started working on the anti-cancer medication legislation in 2019 while an advocate for the Leukemia and Lymphoma Society (now Blood Cancer United). This win is for the people who are battling cancer and need treatment options,” Bruce said. “I'm glad to be a part of this win for Idaho.”
Volunteer advocates of the American Cancer Society Cancer Action Network (ACS CAN) are grateful to Rep. Bruce for his leadership on this issue.
“Dealing with cancer is a life-changing thing and all cancer patients deserve to have the most affordable and most effective treatment possible,” said Randy Johnson, ACS CAN Idaho Government Relations Director. “This law will help make it easier for individuals with cancer to access the right treatment for them and that can make all the difference in surviving this disease.”