A $100 co-payment is reasonable for pills that cost thousands of dollars and that save patients trips to the hospital or clinic.
The Senate should accept the Assembly’s demand for a co-payment, capped at $100 per month, so Wisconsin’s chemotherapy bill can quickly becomes law.
Sen. Alberta Darling, R-River Hills, a cancer survivor and proponent of Senate Bill 300, endorsed the change Monday and urged her Senate colleagues to accept the Assembly version of the bill April 1. That’s when the Senate plans to meet for the last time on regular business this year.
The governor says he will sign the bill with or without the co-pay. So the only way this needed coverage standard won’t become law is if the Senate and Assembly can’t agree.
A $100 monthly co-pay is worth getting this legislation done, and it appears most of the politicians and advocates now agree.
The pills allow cancer patients to avoid driving to a health care provider to receive chemotherapy treatment intravenously.
SB 300 will require insurers to provide the same coverage for chemotherapy in pill form as they now do for chemo through an IV, or to limit co-payments to no more than $100 per month. Some health plans have been requiring patients to pay thousands of dollars for the pills because they are a prescription drug, rather than a medical service.
Chemotherapy is expensive regardless of how it is provided. But for many patients, it extends or even saves their lives. Cancer patients deserve the convenience of the pills. This also saves time for health care providers who don’t have to administer an IV.
The co-payment won’t make much of a dent in the cost of the pills, given how expensive some of them are. Yet co-payments are routine — and make sense — for most prescriptions and services. They help guard against excessive treatment and can steer patients to lower-cost options.
Most states have required insurance providers to cover chemotherapy pills. And most states, according to Assembly Majority Leader Pat Strachota, R-West Bend, allow a co-pay.
The Senate should accept the Assembly’s change so this important legislation can move forward.