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Updated 02/05/2012 05:00 AM

Healthy Living: Chemotherapy pills now covered by insurance

By: Katie Gibas

Cancer patients in New York might see some reduced bills this year as insurance companies are now required to cover chemotherapy pills the same way they would cover intravenous treatment. Our Katie Gibas tells us what this means for patients and the entire field of oncology.

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NEW YORK STATE -- In addition to worrying about the side effects of treatment, cancer patients often have another burden they have to deal with on the road to recovery.

"The last thing you want to have to worry about when you're going through therapy for a malignancy, often a very serious malignancy is to worry about the financial impact that this is having on your day to day life and the life of your family," said Dr. John Gullo, Hematology-Oncology Associates of CNY President.

But for patients who take oral chemotherapy pills, a bit of that financial burden has been taken away. The New York State Legislature joins about a dozen other states in requiring insurance companies to pay for the chemotherapy pills. The pills can cost as much as $6,000 per month.

Previously, patients would have to pay a percentage of the cost of the pill, which could still equal thousands of dollars every time they pick up their prescription. Now, the chemotherapy pills will cost the same as a co-pay for traditional intravenous chemotherapy in a doctor's office.

"This goes a long way in establishing parity and fairness for the patient who is prescribed oral drugs," said Gullo.

And for many patients, the pill isn't just a more convenient option, it is the only option.

"Many of these diseases depend solely on maybe one or two of these oral drugs and nothing else seems to work. So it's not like you can substitute and intravenous drugs because a person can't afford or their policy doesn't cover an oral drug. There simply isn't an alternative most of the time," said Gullo.

Doctors say with a reduced financial burden, there will likely be more of a demand for the pills, which they say will have widespread benefits.

"It should encourage research and development for other effective oral forms of therapy. And this has clearly been the trend in oncology in the last few years is to develop more and more targeted drugs, drugs that work at a very specific molecular level. And associated with that often is much less toxicity," said Gullo.

Right now there is a bill in Congress to require all insurance companies to cover chemotherapy pills.