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Oral cancer drugs often not covered fully by insurers

Posted On Mon, February 22, 2010

A new study has found that while oral cancer drugs have become increasingly popular in recent years, some aspects of the therapies associated with them may lead to them not being fully covered by some health insurance plans.

According to a recent study conducted by Avalere Health that was sponsored by the Community Oncology Alliance, a review of 2009 Medicare data found that many oral cancer drugs are placed in the highest price tier and not covered by insurers.

"The new 'smart' oral cancer drugs, which are much more targeted and precise, are generally covered under patients' prescription drug plans, rather than under their medical plans," explained Dr. Patrick Cobb, president of COA. "Patients are then left to foot a large portion of the bill - typically 25-50 percent of the cost. This can add up to thousands of dollars a year - and sometimes thousands of dollars per month."

The reason for the lack of coverage from many insurers is because of many procedures and treatments that come with the oral medications that are designed to manage side effects and monitor patient compliance. Because such treatments are not covered by many insurance companies under any circumstances, patients are often left to foot the bill or potentially stop treatment.

For those in need of oral cancer treatments that are not fully covered by their insurer, taking a look online to see if any health insurance plans do provide full coverage at ideal rates.
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