Transcript Until there is a cure…there is the IMF

HR 2746: The Cancer
Coverage Parity Act of 2011
Women in Government
Oncology Task Force
July 28, 2011
August 2011
“Until there is a cure…there is the IMF”
Agenda
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Introduction
Oral Cancer Drug Parity Background
HR 2746 – Cancer Coverage Parity Act of 2011
What Can You Do to Help?
• How to schedule a meeting
• What to say / talking points
• Do’s & Don’ts
• Tips for Town Hall Meetings
All-Star Advocates
Conclusion
Next Steps
Questions & Answers
“Until there is a cure…there is the IMF”
Advocacy Training Team
Meghan Buzby
410-252-3457
[email protected]
Christina Vargas
310-592-3201
[email protected]
“Until there is a cure…there is the IMF”
Oral Cancer Drug Parity Background
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Historically, chemotherapy has been administered intravenously (IV) in a
physician’s office. However, as innovation has continued to evolve, oral
therapies represent an increasing number of prescribed oncolytics.
– 25-35% of the medications in the oncology development pipeline are
oral therapies.
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Intravenous (IV) cancer medications are typically covered under a health
plan’s medical benefit. In this situation, patients are usually required to
pay an office visit co-payment and are not required to pay a separate fee
for the drug.
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Orally administered cancer medications are typically covered under a
health plan’s pharmacy benefit, and some plans require patients to pay
high out of pocket copays to fill these prescriptions (avg OOP in 2009:
$2942, up 17% from 2008).
“Until there is a cure…there is the IMF”
Oral Cancer Drug Parity Background
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High out-of-pocket costs for treatment places financial hardship on many
cancer patients. When confronted with this reality, some choose to forgo
treatment.
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A new study found that 10% of patients did NOT fill their initial
prescriptions for oral anti-cancer medications due to high rates of
cost-sharing.
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There are no intravenous substitutes for many oral chemotherapy drugs.
Therefore, patients are forced to pay a much higher cost for necessary
treatment.
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Patients affected by this issue include multiple myeloma, leukemia, breast,
kidney, and many more patients.
“Until there is a cure…there is the IMF”
State Legislative Landscape
• Several states have already enacted
cancer drug parity laws including:
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OR (2008)
IN, IA, VT, HI (2009)
CT, KS, CO, MN(2010)
NM, WA, TX, IL (2011)
*The legislation was passed in the
District of Columbia in 2009.
• States with bills awaiting the governors
signature:
– New York
• Bills introduced this year: WI, CA, MO
GA, OK, TN, NJ, MI, OH, MA, PA, SC
“Until there is a cure…there is the IMF”
The Patients Equal Access Coalition (PEAC) is a patient-focused coalition of
organizations representing patients, industry, health care professionals and care
centers collaboratively working to ensure that cancer patients have equal access
(and equality of insurance coverage) to all approved anticancer regimens
including, but not limited to, oral and intravenous drugs, injections, surgery,
radiation, transplantations, etc.
PEAC’S POSITION:
Every cancer patient should have access to the treatments recommended by
their physicians. The Patient Equal Access Coalition (PEAC) believes that
patients should not suffer from cost discrimination based on the type of therapy
provided or the mechanism for the delivery of that therapy.
“Until there is a cure…there is the IMF”
HR 2746, the Cancer Coverage Parity Act of 2011
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Introduced earlier this month by Representative Brian Higgins (NY-27)
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Any health plan that provides coverage for cancer chemotherapy
treatment shall provide coverage for prescribed, orally administered
anticancer medication that has been approved by the FDA.
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Orally administered medication shall be provided at a cost not to
exceed the coinsurance percentage or the copayment amount of an
intravenously, port administered or an injected cancer medication.
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A health plan shall not achieve compliance by imposing an increase in
patient out-of-pocket costs.
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Health plans shall not reclassify such anticancer medications, whether
orally-administered, intravenously or port administered or injected, as
other than medical benefits to achieve compliance with legislation.
“Until there is a cure…there is the IMF”
Key House Committees
House of Representatives
• Education & The Workforce Committee
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Health, Education, Labor and Pensions Subcommittee (HELP)
• Energy and Commerce Committee
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Health Subcommittee
• Ways and Means Committee
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Health Subcommittee
“Until there is a cure…there is the IMF”
What Can You Do?
• Ask your US Representative to co-sponsor
HR 2746, the Cancer Coverage Parity Act
of 2011:
– Send an email through the IMF Action Center
– Schedule a face-to-face meeting with your
Rep. in your district
– Attend a Town Hall Meeting
“Until there is a cure…there is the IMF”
Email Your Representative
• Visit www.advocacy.myeloma.org
• Click on Issues & Legislation tab at the top
• Click on the Current Action Alert: Help
Eliminate the Disparity in Coverage for
Chemotherapy
• Fill in your personal story in the area provided
and your personal information at the bottom
• Your email will be automatically sent to your US
Representative based upon your address
information
“Until there is a cure…there is the IMF”
Personal District Visits
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Locate your US Representative
on the Action Center
PHONE Appt
Secretary/Scheduler of district
office noting that you are a
constituent
Scheduler normally will ask for
a letter to be faxed or e-mailed
with details of who, when, and
why – We have a template
letter for you to use!
If your Representative cannot
meet with you, ask to meet
with his/her Health LA
(legislative assistant) or Staff
Director
“Until there is a cure…there is the IMF”
Personal District Visits
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Arrive at least 10 minutes early to your meeting
Once in the meeting, introduce yourself. Be sure to tell them
where you live (often times this is an easy way to connect with
your Representative).
Thank them for their time and explain why you are there to
meet with them – be specific!
• “I am here to discuss HR 2746, the Cancer Coverage
Parity Act of 2011 and ask for your co-sponsorship.”
Use the talking points given to you from the IMF to explain the
issue better
Make it personal!
Ask them again to please co-sponsor HR 2746.
Leave the materials provided by the IMF with the Rep. or
staffer
Thank them again for their time and consideration 
“Until there is a cure…there is the IMF”
Group Visits
• A small group of constituents can provide
multiple perspectives on an issue.
• Assign someone as meeting facilitator who
makes introductions, designates certain
people to speak on particular issues, and
wraps up the meeting.
• Assign another person as note taker to record
what happens at the meeting and the
legislator’s response.
• Be sure to say thank you and leave materials
behind.
“Until there is a cure…there is the IMF”
Talking Points for Your Meeting
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Today, oral oncology therapies comprise about 10% available therapies. It is
estimated that 25-35% of the medications in the oncology development
pipeline are oral therapies.
Cancer patients should have equal access to all approved anticancer regimens
regardless of how they are delivered.
Patients and their physicians should make decisions about treatment based on
what will give the patient the best chance of survival, NOT based on insurance
coverage.
Many new oral drugs do NOT have IV alternatives so there isn’t a choice for
treatment.
Since myeloma is a relapsing and remitting disease, patients will have to use all
approved treatments (including orals) at some point during the course of
treatment. It is IMPERATIVE that they have ACCESS to all of them EQUALLY.
HR 2746 ensures that IF a health plan covers chemotherapy- they must cover
oral chemotherapy at the same reimbursement rate as chemotherapy given via
IV or injection
This is not a mandate. It will only apply to health plans that already cover
chemotherapy
“Until there is a cure…there is the IMF”
Town Hall Meetings
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Contact the Advocacy Team to find out if there is a town hall meeting in
your area
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Learn the established procedures
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Be prepared in advance with your specific question:
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Will you co-sponsor HR 2746, the Cancer Coverage Parity Act?
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Leave behind materials
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Identify yourself and how you have been impacted by cancer
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Be polite and professional
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Ask for a response to your question
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Use your judgment
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Introduce yourself to the Member before or after the meeting
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Report back to the Advocacy team on the results of the meeting
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Follow up!
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Plan ahead, be prepared
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Be prompt, patient, and flexible
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Introduce yourself & mention
that you’re a constituent of the
representative’s district
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Be concise and stick to the
talking points – but don’t be
afraid to share why this issue is
important to you personally!
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Relax and remember that a
conversation is a two-way
street…
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Be respectful & thank your
representative for meeting with
you
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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It’s okay to say “I don’t know”
(credibility lost is hard to regain)
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Ask your representative to support
the bill & share your leavebehind materials
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
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Follow-up
“Until there is a cure…there is the IMF”
Top Ten Do’s & Don’ts
#1
ENJOY MAKING AN IMPACT!!
“Until there is a cure…there is the IMF”
All-Star Advocates
Waterbury, CT Support Group
Leaders, Robin & Michael Tuohy
provided oral testimony in support
of SB 50, the oral parity bill in CT
Contact:
Robin & Michael Tuohy
203-206-3536
[email protected]
Central New Jersey Support
Group Leader, Paula Van Riper
provided oral testimony to the
Assembly Health Committee
where it passed unanimously
Contact:
Paula Van Riper
908-725-4948
[email protected]
David Cowan, from Eunice, New
Mexico, shared his story with
the House, Health &
Government Affairs Committee
Contact:
David Cowan
575-394-2061
[email protected]
“Until there is a cure…there is the IMF”
All-Star Advocates
Norfolk, VA / Northeast NC
Support Group Leader, Jerry
Walton visited with his 2
Senators and Representative in
DC
San Francisco / Greater Bay
Support Group Leader, Jack
Aiello visited with his 2
Senators and Representative
in DC
Contact:
Jerry Walton
757-495-8432
[email protected]
Contact:
Jack Aiello
408-691-6999
[email protected]
“Until there is a cure…there is the IMF”
Remember…
“Those who consider themselves
too smart to get involved in
politics are punished by being
governed by those who are
dumber than they are.”
– Bart Simpson
“Until there is a cure…there is the IMF”
Next Steps
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District Visit Info Sheet
Advocacy Toolkit
Talking Points & sample letters
Leave Behind Materials
Follow up
“Until there is a cure…there is the IMF”
THANK YOU!!
Questions & Answers
“Until there is a cure…there is the IMF”