Equal Costs for Cancer Drugs: Oral vs. Provider-Administered
This new law aims to equalize the costs of cancer medications, whether taken orally at home or administered intravenously by a healthcare provider. This means health insurance plans cannot charge more for oral medications, potentially reducing patients' out-of-pocket expenses for treatment. The changes will take effect from January 1, 2026.
Key points
Health insurance plans must cover oral cancer drugs with cost-sharing no less favorable than for provider-administered cancer drugs.
Plans are prohibited from increasing out-of-pocket costs or reclassifying benefits to circumvent these new rules.
The law does not mandate the use of oral medications over other forms of treatment and allows for prior authorization.
A study will be conducted within two years to assess the law's impact on patients' treatment costs.
Introduced
Citizen Poll