Cancer Drug Parity Act of 2021

Cancer Drug Parity Act of 2021

This bill requires group health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. This requirement applies to medications that are (1) approved by the Food and Drug Administration; (2) medically necessary for the cancer treatment; and (3) clinically appropriate in terms of type, frequency, extent site, and duration.

To comply with this requirement, plans may not, with respect to anticancer medications (1) change or replace benefits to increase out-of-pocket costs, (2) reclassify benefits to increase costs, or (3) apply more restrictive limitations to orally administered medications than to intravenously administered or injected medications.

Bill 117 HR 4385, also known as the Cancer Drug Parity Act of 2021, is a piece of legislation currently being considered by the US Congress. The main goal of this bill is to ensure that patients who are undergoing treatment for cancer have access to affordable and effective medications.

One of the key provisions of the Cancer Drug Parity Act is that it would require insurance companies to provide coverage for orally administered cancer drugs on terms that are no less favorable than coverage for intravenously administered cancer drugs. This is important because many cancer patients rely on oral medications for their treatment, and these drugs can be expensive and difficult to access.

Additionally, the bill would prohibit insurance companies from imposing higher out-of-pocket costs for oral cancer drugs compared to intravenous drugs. This would help to ensure that cancer patients are not financially burdened by their treatment and can focus on their recovery. Overall, the Cancer Drug Parity Act of 2021 aims to level the playing field for cancer patients and ensure that they have access to the medications they need to fight their disease. By providing equal coverage for oral and intravenous cancer drugs, this bill seeks to make cancer treatment more affordable and accessible for all patients.