Hi! I haven't posted in a loooong time. Many heartfelt thanks to all who do.
This is a "heads up" about legislation that may be coming to your state. I recently discovered that Washington State changed coverage for all drugs classified as "oral chemotherapy". This change will be a great help to some, but has unintended consequences for many of us. I discovered this when I showed up to pay my $20 copay for Gleevec at Walgreens only to presented with a bill for $1384.42! This is due to a recently passed bill to help those who are taking oral chemo drugs that kill cancer cells and can be injected or given intravenously. While Gleevec fits none of these characteristics, it is still classified with the other "oral chemo" drugs. This bill switches all oral chemo drugs, and Gleevec, from my prescription benefit into my Medical plan which has a $1500 deductible. Luckily, I am blessed to be working and can pay it, although it certainly makes my budget tight for awhile! The Washington State Insurance Commission representative felt that Gleevec may be wrongly classified and I have filed a complaint.
You may want to check with your state legislators to make sure that any legislation in your state has the right language before it is instituted and see how this effects your health plan (mine is Premera Blue Cross). I have no idea how this impacts those on Medicare. Here is a statement from Novartis at a hearing before this law (Washington State Bill 1517) went into effect:
"• Novartis Oncology supports language that improves patient access to oral anti-cancer medications, but feels parity may result in unintended consequences. It states that their oral cancer drug, Glivec, is already adequately covered under most pharmacy benefits and that parity would result in a large increase in out-of-pocket costs for many patients. Novartis recommends specific protective language be added to the bill to prohibit movement from the pharmacy to the medical benefit."
Apparently, this is an initiative that many states are looking into. I plan to talk with someone from Novartis next week. Blue Cross told me that they don't classify drugs, something called "Medco"
Thanks, Lynn N