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Weinberg-Gill Measure To Ensure Insurance Coverage For Oral Cancer Drugs Advances

A view of the Senate Chambers from the 2010-2011 Senate Reorganization.

Measure Would Require that Oral Cancer Drugs Are Covered on Similar Basis to Intravenous Cancer Drugs

TRENTON – A bill sponsored by Senators Loretta Weinberg and Nia H. Gill which would require that all health insurers in New Jersey cover orally-administered cancer medications under similar terms and conditions used in the coverage for intravenous or injected cancer drugs was approved by the Senate Budget and Appropriations Committee today by a vote of 10-1.

“Thanks to the research over the past decade, orally-administered cancer drugs have become more popular compared to the alternatives of intravenous and injected cancer drugs. With these great advancements comes ease of side effects including nausea and hair loss as well as ease of access since oral drugs can be taken at home, rather than at a doctor’s office or clinic,” said Senator Weinberg (D-Bergen), Chairwoman of the Senate Health, Human Services and Senior Citizens Committee. “Unfortunately insurance plans have not kept up with modern cancer care and these orally-administered cancer drugs often come at a much higher price for patients. This bill will bring the law current with medical research and development, allow for orally-administered cancer drugs to be covered the same as other cancer treatments, and provide much relief to cancer patients both medically and financially.”

The bill, S-1834, would require health insurers to provide insurance coverage for prescribed, orally-administered cancer medications on a basis which is no less favorable than the policy or contract provides for injected anticancer medications. Under the bill, insurers would be prohibited from subjecting the coverage of oral cancer medication to any prior authorization stipulations, dollar limits, copayments, deductibles or coinsurance standards that do not apply to intravenously-administered or injected cancer drugs. The bill would also prohibit insurers from imposing new barriers on injected anticancer drugs in order to comply with the provisions of this bill.

“Unfortunately under current law, many orally-administered cancer drug options are covered under prescription drug plans with higher co-pays and annual coverage limits rather than the more inclusive medical plans,” said Senator Gill (D-Essex and Passaic), Chairwoman of the Commerce Committee. “We therefore must change the law so that the cancer patient and the doctor can determine the best treatment option based on medicine rather than the financial status of the patient.”

The bill now heads to the full Senate for consideration.

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