Parity for oral and intravenous/injected cancer drugs

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By Kathryn V. Fitch, Kosuke Iwasaki, Bruce S. Pyenson | 25 January 2010
In standard medical benefit designs, intravenous/injected chemotherapy drugs are usually covered through medical benefits, while oral chemotherapy drugs are covered through pharmacy benefits. Some pharmacy benefit designs require unlimited cost sharing and thus can make high-cost oral cancer treatment medications unaffordable. This report examines the concept of creating parity between oral and intravenous drugs by equalizing patient cost-sharing for all chemotherapy drugs, and also addresses the cost implications of proposed drug parity legislation.

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Healthcare