Kentucky considers restrictions on Medicaid for 3 cancer drugs

The Lexington Herald-LeaderMarch 28, 2011 

FRANKFORT — Kentucky health officials are considering restrictions on the number of cancer-fighting drugs Medicaid patients may receive without prior approval, a move designed to contain costs in the health care program for the poor and disabled.

The possibility of creating a non-preferred list of oral oncology drugs — pills that replace intravenous chemotherapy drugs — that Medicaid won't pay for without prior approval has raised questions from patient advocates and those who treat cancer patients.

Dr. Donald Miller, executive director of the James Graham Brown Cancer Center at the University of Louisville, said he understands the need to cut costs, but limiting cancer drugs may have unintended consequences.

Miller said cancer treatment plans differ greatly depending on the patient, the type of cancer and the stage of the cancer.

"We all have to be concerned about health care costs," Miller said. "We also are concerned that our patients get the very best treatment."

Cabinet for Health and Family Services Secretary Janie Miller will have the final say on the issue, although a committee of health care providers has recommended that she put three oral oncology drugs on Medicaid's non-preferred list.

The drugs in question are a relatively new form of therapy that can be taken orally. The drugs have proven effective in treating cancers and are more convenient for patients. However, the drugs can be expensive, said Donald Miller.

If the state approves the limitations, Kentucky will likely be the first in the country to do so, said James Sharp of the American Cancer Society.

Sharp said several other states have considered similar moves as Medicaid rolls ballooned during tough economic times.

To read the complete article, visit www.kentucky.com.

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