As the Northern Nevada Children’s Cancer Foundation prepares to attend the 2014 Childhood Cancer Action Days on Capitol Hill, we look back at how far we have come in just a year. With the help of a generous donation to NNCCF, we are proud to announce that we are expanding our program to include support for adolescents diagnosed with childhood cancer before their 21st birthday and through treatment until their 23rd birthday, a group often referred to as Adolescents and Young Adults (AYA). Being able to serve this age group helps to align NNCCF with other national organizations, brings NNCCF to a whole new level of care and allows help to extend to a greater number of people. Previously NNCCF was only able to help those diagnosed before their 18th birthday.

 In addition to the program expansion, Nevada has passed the Oral Chemotherapy Parity Law. NNCCF is relieved to see the shift in legislation now allowing families to receive oral chemotherapy without the burden of extremely high co-pays. According to the International Myeloma Foundation, traditionally, IV chemotherapy treatments are covered under a health plan’s medical benefit where the patient is required to pay an office visit copay, usually between $20 and $30. Conversely, oral anticancer medications are covered under a health plan’s prescription benefit and, many times, patients are responsible for extremely high and unmanageable copays, creating an enormous barrier for patients to access orally administered drugs. According to a recent study published in the Journal of Oncology Practice and American Journal of Managed Care, 10% of cancer patients failed to fill their initial prescriptions for oral anticancer medications due to high out-of-pocket costs.

 Legislative Solution

In an effort to remove barriers to accessing life-saving treatments for cancer patients, Nevada implemented legislation for health policies issued or renewed on or after January 1, 2015. This law requires health policies that provide coverage for the treatment of cancer through chemotherapy must not require a co-payment, co-insurance or deductible of more than $100 per prescription for orally administered anticancer treatment. Additionally, plans may not increase the out-of-pocket cost to patients to achieve compliance.

 What Does This Mean for Patients?

If a patient is privately insured (the law does not apply to Medicare or Medicare supplemental plans), and their plan covers chemotherapy, an FDA-approved, orally administered drug should have a maximum of $100 co-payment per prescription.

Along with all of these positive changes, the Nevada Cancer Coalition is currently in the process of re-writing the strategic plan for the state. Moving forward, NNCCF will have a voice in this plan and the NNCCF team is excited to see what Childhood Cancer Action Days will bring at the end of June.