Medicare Patients Can't Get 'Cancer Pill'

Expert: ‘These medicines keep people out of hospital and extend their lives’

WND

Rapid progress continues on oral chemotherapy treatments that are far more effective and less toxic than conventional alternatives, but the inability of Medicare and insurance companies to offer comparable coverage is draining the resources of many patients and leaving others unable to pursue treatment.

The mapping of the human genome has allowed doctors to determine which parts of cells are compromised by cancer and responsible for spreading it. As a result, oral chemotherapy allows for much more effective treatment against killers like myeloma, breast cancer and pancreatic cancer. It’s also far less toxic than traditional chemotherapy because the targeting of the medication requires far smaller dosages that wreak far less havoc on the immune system.

“What we’re seeing as a result of the new oral medicines is what we saw with HIV when you give a combination of treatments that’s matched to the way your genes respond to the disease and drug and you’re saving lives of people who otherwise would be dying early,” said Robert Goldberg, founder and vice president of the Center for Medicine in the Public Interest, who wrote on the promise and financial frustration of these advancements in the May 8 edition of the New York Post.

So why are Medicare and insurance companies content to cover virtually the entire tab for conventional chemotherapy but not for the more effective and less harrowing oral drugs? Goldberg told WND it mostly comes down to money.

“There’s this disconnect between medical innovation and how insurance and Medicare are paying for things. First, it’s easier to get more payment for injections than it is to get for oral medications. Also physicians tend to get reimbursed more for injections than they do for dispensing a pill. They actually get paid for infusing, whereas for running a prescription there’s no extra fee that they can collect,” Goldberg said. “The second reason is, unfortunately, an obvious one. If you can shift the cost to the consumer, you see just how much you can get away with paying.

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Reposted with permission.