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Impact of parity legislation on use and costs of oral cancer medications
Investigator (PI): Dusetzina, Stacie
Performing Organization (PO): (Current): University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy / (919) 966-1169
Supporting Agency (SA): American Cancer Society
Initial Year: 2014
Final Year: 2016
Record Source/Award ID: ACS/0
Funding: Total Award Amount: $480,000
2014 Award Amount: $480,000
Award Type: Grant
Abstract: The use of oral drugs for treating cancer has increased over time. Many patients prefer oral medications because they can be taken at home, allowing patients to avoid frequent trips to the doctor's office or hospital, and minimizing interference with their daily lives. Unfortunately, oral cancer treatments can be very expensive for patients because of differences in how insurance plans pay for intravenous and oral medications. People who receive infused (IV) chemotherapy often only pay a relatively small copayment for the office visit during which they receive chemotherapy. On the other hand, people treated with oral cancer medications pay copayments or co-insurance when they obtain their medications from the pharmacy each month, which can be very expensive over a course of treatment. These higher costs make it harder for some patients to take their drugs as prescribed. By the end of 2012, 18 states and the District of Columbia had enacted laws to create "cancer parity" that mandates that patients pay the same price for oral and IV drugs offered by the same health plan. Since April 2013, the U.S. House of Representatives has been considering similar legislation that would apply to all states and private insurance plans. The federal expansion of parity is important for ensuring equal access to oral cancer medications for patients across states and for the 60% of privately insured patients who are enrolled in health plans that are currently exempt from state parity laws. The effect of state cancer parity laws on the use and costs of cancer care is unknown. We plan to measure the effect of state parity laws on use of cancer medications, health care spending, and patients' medication-taking behaviors. Our study will provide timely and much-needed evidence to policy makers, patients, and health plans about the impact that state cancer parity laws have had to date. We believe that this information could be used as a basis for advancing federal legislative efforts to increase access to oral cancer medications for privately insured patients who would benefit from those therapies. Further, by providing evidence of the effect of such policies that are intended to improve access to life-extending medications, the experience of private insurance plans may inform changes to public insurance plans such as Medicaid and, importantly, Medicare-the primary payer for cancer care in the U.S.
MeSH Terms:
  • Administration, Intravenous
  • Antineoplastic Agents /*administration & dosage
  • /*economics
  • Evidence-Based Medicine
  • Health Care Costs
  • Health Policy
  • Health Services Accessibility
  • Humans
  • Infusions, Intravenous
  • Insurance, Health
  • Medicaid
  • Medicare
  • Mouth Neoplasms /*drug therapy
  • /*economics
  • United States
Country: United States
State: North Carolina
Zip Code: 27599
UI: 20154061
Project Status: Completed