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 ”

• 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 ”

Meghan Buzby
410-252-3457 mbuzby@myeloma.org
Christina Vargas
310-592-3201 cvargas@myeloma.org
“Until there is a cure…there is the IMF ”

• 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.
• 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.
• 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 ”

• High out-of-pocket costs for treatment places financial hardship on many cancer patients. When confronted with this reality, some choose to forgo treatment.
• 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.
• There are no intravenous substitutes for many oral chemotherapy drugs.
Therefore, patients are forced to pay a much higher cost for necessary treatment.
• Patients affected by this issue include multiple myeloma, leukemia, breast, kidney, and many more patients.
“Until there is a cure…there is the IMF ”

• Several states have already enacted cancer drug parity laws including:
– 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 P OSITION :
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
• Introduced earlier this month by Representative Brian Higgins (NY-27)
• 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.
• 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.
• A health plan shall not achieve compliance by imposing an increase in patient out-of-pocket costs.
• 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 ”

House of Representatives
• Education & The Workforce Committee
• Health, Education, Labor and Pensions Subcommittee (HELP)
• Energy and Commerce Committee
• Health Subcommittee
• Ways and Means Committee
• Health Subcommittee
“Until there is a cure…there is the IMF ”

• 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 ”

• 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 ”

• 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 ”

• 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 ”

• 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 ”

• 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 ”

• Contact the Advocacy Team to find out if there is a town hall meeting in your area
• Learn the established procedures
• Be prepared in advance with your specific question:
– Will you co-sponsor HR 2746, the Cancer Coverage Parity Act?
– Leave behind materials
• Identify yourself and how you have been impacted by cancer
• Be polite and professional
• Ask for a response to your question
• Use your judgment
• Introduce yourself to the Member before or after the meeting
• Report back to the Advocacy team on the results of the meeting
• Follow up!
“Until there is a cure…there is the IMF ”

#10
Plan ahead, be prepared
“Until there is a cure…there is the IMF ”

#9
Be prompt, patient, and flexible
“Until there is a cure…there is the IMF ”

#8
Introduce yourself & mention that you’re a constituent of the representative’s district
“Until there is a cure…there is the IMF ”

#7
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 ”

#6
Relax and remember that a conversation is a two-way street…
“Until there is a cure…there is the IMF ”

#5
Be respectful & thank your representative for meeting with you
“Until there is a cure…there is the IMF ”

#4
It’s okay to say “I don’t know”
(credibility lost is hard to regain)
“Until there is a cure…there is the IMF ”

#3
Ask your representative to support the bill & share your leavebehind materials
“Until there is a cure…there is the IMF ”

#2
Follow-up
“Until there is a cure…there is the IMF ”

#1
ENJOY MAKING AN IMPACT!!
“Until there is a cure…there is the IMF ”

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 tuohy@snet.net
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 pvanriper1122@gmail.com
David Cowan, from Eunice, New
Mexico, shared his story with the House, Health &
Government Affairs Committee
Contact:
David Cowan
575-394-2061 decowan@hotmail.com
“Until there is a cure…there is the IMF ”

Norfolk, VA / Northeast NC
Support Group Leader, Jerry
Walton visited with his 2
Senators and Representative in
DC
Contact:
Jerry Walton
757-495-8432 jerryewalton@cox.net
San Francisco / Greater Bay
Support Group Leader, Jack
Aiello visited with his 2
Senators and Representative in DC
Contact:
Jack Aiello
408-691-6999 jackaiello@comcast.net
“Until there is a cure…there is the IMF ”

“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 ”

• District Visit Info Sheet
• Advocacy Toolkit
• Talking Points & sample letters
• Leave Behind Materials
• Follow up
“Until there is a cure…there is the IMF ”

“Until there is a cure…there is the IMF ”