The non-profit cancer-therapy consulting group Patient Power is hailing a District of Columbia law that established patient co-pay ceilings on specialty medications for diseases like multiple myeloma.
Co-pays are a common feature of American health insurance plans. The term refers to a patient paying part of the cost of prescriptions or healthcare services. High co-pays can make it difficult for a patient to start a treatment regimen, or continue it.
The District of Columbia law will limit “out-of-pocket payments to $150 for a 30-day supply of specialty medicines and $300 for a 90-day supply,” Esther Schorr, co-founder of Seattle-based Patient Power, said in a press release. “This is critically important not just for patients but for their families. We should never have to make the terrible choice between the health of our loved one and the prospect of bankruptcy or losing our home.”
She and her husband Andrew started Patient Power after he survived leukemia. The organization’s goal is to let cancer patients know about the best medicines to treat their conditions so they can reclaim their health.
California, Delaware, Louisiana, Maine, Maryland, Montana, New York and Vermont have passed legislation similar to the District of Columbia.
The amount of a co-pay can mean the difference between a patient being able to afford a treatment or not, another high-profile leukemia survivor told Patient Power in an interview.
Greg Simon, who survived chronic lymphocytic leukemia, is now executive director of the Biden Foundation’s Cancer Initiative. This foundation is named for former Vice President Joe Biden, who lost his son Beau to cancer.
Simons said reasonable co-pays made his leukemia medications affordable.
New treatments in particular can be very expensive. Reasonable co-pays make them accessible to a lot more patients and help patients stay with treatments for the length of time doctors prescribe.
Reasonable co-payments actually save the healthcare system money by preventing patients from abandoning their treatment regimens, experts say.
Patients who failed to stick with their regimens caused a $105 billion increase in healthcare costs that could have been avoided in 2012, according to a study.
The research, “Clinical Cancer Advances 2012: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology,” was published in the Journal of Clinical Oncology in 2013.
“The [District of Columbia] law doesn’t go into effect until January [of 2018], but we want to acknowledge this important step now amidst all of the turmoil over federal healthcare legislation,” said Andrew Schorr, the other Patient Power co-founder. “High out-of-pocket payments can prevent many patients from taking the full dose of medications they need. Putting a limit on those personal payments can help patients like me. I’ve depended on specialty medications to keep me alive and well and working 21 years since my initial diagnosis.”