More than half a million Americans have some form of metastatic cancer. (Photo by apomares/iStock Getty Images)
A bill that would expand treatment for a certain type of cancer passed the House Economic Development/Banking/Insurance & Commerce Committee unanimously Tuesday afternoon.
House Bill 364, sponsored by Rep. Cyndie Romer, D-Newark, requires that individual, blanket and group health insurance carriers cover drug treatment for the associated conditions of metastatic cancer in the same way treatment for metastatic cancer is covered.
Metastatic cancer is cancer that spreads from its site of origin to another part of the body.Â
According to the National Cancer Institute, there are 623,405 Americans living with metastatic breast, prostate, lung, colorectal, or bladder cancer, or metastatic melanoma.
The bill details âassociated conditionsâ as symptoms or side effects associated with metastatic cancer or its treatment and which, in the judgment of the health care practitioner, further jeopardizes the health of a patient if left untreated.
Under the bill, insurance companies would need to cover any FDA-approved drug prescribed to treat the side effects of metastatic cancer treatment.
It would also prohibit insurance companies from mandating that patients first fail to respond to a different drug or prove a history of failure of such drug.
Step therapy, also called âfail-first,â is a process that requires patients to try and fail on one or more medications chosen by their insurer before they can access the optimal treatment recommended and prescribed by their healthcare provider.
Romer pointed out this is only specific to the conditions caused by cancer, so for example, if someone has cancer but is getting treatment for a sprained ankle, the patient could still have to go through step therapy for that.
There is no fiscal impact on the state if the bill becomes law.Â
If enacted, the bill would go into effect Dec. 1, 2025.
HB 364 now heads to the House floor for debate.
Raised in Doylestown, Pennsylvania, Jarek earned a B.A. in journalism and a B.A. in political science from Temple University in 2021. After running CNNâs Michael Smerconishâs YouTube channel, Jarek became a reporter for the Bucks County Herald before joining Delaware LIVE News.
Jarek can be reached by email at [email protected] or by phone at (215) 450-9982. Follow him on Twitter @jarekrutz
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