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Patients fighting to get oral chemo treatments covered by health insurance

Posted at 6:07 PM, Jun 08, 2018
and last updated 2018-06-10 10:42:08-04

Cancer patients are fighting to get the treatment they need covered by health insurance, once again imploring Michigan Legislators to do what 43 other states have already done: require insurance companies to provide equal coverage for both oral chemotherapy and IV chemotherapy.

That would allow patients to get the treatment their doctors prescribe instead of what they can afford. 

For many it's a matter of life and death. For some its about quality of their life and what's more effective in addressing the form of cancer they are fighting. 

Michigan is 1 of 7 states without oral chemo legislation and Yona Nivy says she just doesn't understand. 

"I don’t understand for one moment why 43 states have passed this and Michigan has not," says Nivy.

Nivy is a grandmother, still hard at work for her family’s business, even in the midst of a 15 year long battle with cancer.

"I thought I was going to be diagnosed with pneumonia and it turned out to be small cell lung cancer. I wasn’t a smoker or even near second hand smoke," says Nivy.

Lung cancer was followed by ovarian cancer and then, the IV Chemotherapy treatments stopped working. 

"I had an allergic reaction because I’d been on it for so many years," she explains. "My doctor tried to come up with different IV cocktails, but nothing was really working and the options seemed to be non-existent."

When the FDA approved oral chemotherapy in a pill form, it seemed like a miracle at first. 

"I don’t want to say that the oral chemo is a cake walk but it is in comparison." says Nivy. 

The treatment works and the side effects are significantly less. Then the phone call came, her health insurance wouldn’t cover the cost.

"Can you afford 12 to 15 thousand dollars a month? And it took my breath away! And I just sort of said, who can?" 

Some patients go into debt. 

"I know the story of someone who passed away and the family is still paying cause they had to take out loans for that."

For Nivy, oral chemo has been the difference between life and death. 

"It’s been life saving. It’s given me 3 more years to work and be productive, pay taxes in Michigan, be with my family, my children. In the last three years I’ve become a grandmother twice," says Nivy.

Which is why patients and advocates have been fighting for years to get a bill passed that would require health insurance to cover IV chemo and oral chemo equally.  

Yesterday’s hearing in the state house was over before it began.

For More info on the fight for equal cos erase check out these links: https://www.acscan.org/oral-chemotherapy-fairness-michigan

Legislation has been introduced in Michigan.

Senate Bill 492 Introduced by State Senator Geoff Hansen: http://legislature.mi.gov/doc.aspx?2017-SB-0492

House Bill 5367 Introduced by State Representative Daire Rendon: http://legislature.mi.gov/doc.aspx?2017-HB-5367

Take Action Here for Oral Chemotherapy Fairness in Michigan: http://action.acscan.org/site/Advocacy?pagename=homepage&id=14842