Guest Opinions

Idaho cancer patients deserve legislation governing fair treatment costs

Sheri Baker
Sheri Baker

I’ve lived in Idaho most of my adult life. I raised my children here, and now I have a grandbaby. And I lived here when I got my cancer diagnosis seven years ago.

Since then, I’ve been through a number of procedures and undergone treatments to keep my cancer under control. I count myself lucky that it’s worked, and that I’ve had access to these treatments.

But because I also run a local myeloma support group, I know stories of those who aren’t so lucky, those who have had to make a choice about their treatment based not on what their oncologist advised, but rather what their insurer would cover. That’s wrong, and it’s time Idaho joins with most of the other states in the country to make it right.

For the most part there are two types of cancer treatments — IV and oral. But for many patients that’s where the similarities end. Some insurance companies continue to cover IV chemotherapy in a different way than they do the oral medications. It has to do with how the treatments are classified — the IV is covered under most patients’ medical benefit, while the pills are covered under a prescription benefit. What that translates to is potentially a huge out-of-pocket cost differential for the patient. The IV treatment typically has a very small copay, similar to what you pay when you go to a doctor’s office. The pills can be thousands of dollars out of a patient’s pocket.

It’s unfair. Many cancers have only oral treatments, so there is no choice for those patients but to shoulder the cost. Some cancers need to be fought with a combination of IV and oral, so patients face a hurdle in that way.

Nearly every state in the nation, with the dubious exception of Idaho and six others, has passed legislation to help bring fairness to this equation. Patients and their doctors shouldn’t have to choose a treatment plan based on who their insurer is and what they cover, but rather on what will be most effective in fighting their disease.

I urge Idaho’s leaders to take a serious look at changing this for patients. We are fortunate to live in a time where cancer is able to be managed and treated. We still have a long way to go before we get to a cure, but we need to give our friends and neighbors access to every available treatment. Lives depend on it.

Sheri Baker is a Boise cancer support group leader.