The many challenges cancer patients must face now include finding out which cancer drugs are covered by health insurance plans purchased through the marketplaces created by the Affordable Care Act (ACA). A recent study, conducted by researchers from the American Cancer Society Cancer Action Network (ACS CAN), evaluated marketplace formularies in California, Florida, Illinois, North Carolina, Texas and Washington -- part of an initiative to be sure ACA's patient protection measures are working well.
“Having access to accurate, up-to-date prescription information is imperative for cancer patients, survivors and their loved ones as they work to make informed decisions about the best health coverage for them and their families,” ACS CAN President Chris Hansen said. “Cancer patients should not have to struggle to understand their plan options or, worse, risk choosing a plan that doesn’t meet their needs based on inaccurate or inadequate information.”
The study also found that getting information about a plan's drug formulary was often made more difficult by cost-sharing information inconsistencies; that marketplace plans often placed cancer drugs on their highest tiers; and that cancer patients often struggled with coverage limits.
As a result of the study, ACS CAN has recommended to states and the HHS that transparency of coverage and cost-sharing should be increased.
"As treatments and therapies continue to reflect increased understanding of cancer at the molecular level, it is imperative that health plans design and communicate their benefits in a way that ensures adequate, timely and affordable access to prescription drugs that are necessary [to] reduce death and suffering from cancer,” Hansen said.
