Bill Summary for Bill Number SB09-250

Date: 04/30/2009

Final
BILL SUMMARY for SB09-250

HOUSE COMMITTEE ON STATE, VETERANS, & MILITARY AFFAIRS

Votes: View-->	Action Taken:
Moved prepared amendment L.011 (Attachment H). Th Moved to refer Senate Bill 09-250, as amended, to	PASS PASS

11:49 AM

The committee was called to order. A quorum was present.

11:50 AM -- Senate Bill 09-250

Representative Primavera, prime sponsor, presented Senate Bill 09-250, concerning health benefit plan coverage for oral anti-cancer medication. Representative Primavera explained the effect of the bill, and discussed the need for the legislation. Representative Primavera also discussed the effect of similar legislation adopted in Oregon. Committee members received a table detailing the effect of the Oregon legislation on health insurance policies (Attachment A) and a rate filing summary for Oregon (Attachment B).

11:53 AM

The following persons testified regarding Senate Bill 09-250:

11:53 AM -- Dr. Nicholas DiBella, representing the Rocky Mountain Cancer Centers, testified in favor of the bill. Dr. DiBella discussed circumstances in which oral anti-cancer drugs are more effective treatments than other regimens, and explained that oncologists do not prescribe oral medications for personal financial gain. Dr. DiBella responded to questions regarding the number of drugs prescribed for oral cancer treatment, and the need for the bill. Mr. DiBella responded to further questions regarding coverage of the drug treatments by insurers at present, and the efficacy of the drugs in comparison to intravenous cancer drugs. Discussion ensued regarding the role of the state in mandating coverage of oral cancer drugs, and the ability to secure coverage for the drugs without legislation.

12:01 PM -- Dr. Lynn Parry, representing the Colorado Prescription Coalition, testified in opposition to Senate Bill 09-250. Committee members received a fact sheet detailing the coalition's objections to the bill (Attachment C). Dr. Parry discussed the impact of drawing money away from insurance coverage resources, and alternatives for ensuring cancer patients receive proper treatments.

12:04 PM -- Mr. Travis Berry, representing the Colorado Competitive Council, testified in opposition to the bill. Mr. Berry discussed the impact of making health care coverage more expensive, and the ability to treat cancer with forms of treatment other than oral medications. Mr. Berry also discussed the need to keep health care decisions at the doctor/patient level, and costs associated with drug development.

12:10 PM -- Mr. Ben Price, representing the Colorado Association of Health Plans, testified in opposition to Senate Bill 09-250. Committee members received an article from the Wall Street Journal concerning rising drug and hospital treatment prices (Attachment D). Mr. Price discussed the cost of administering oral anti-cancer medicines, and the impact of requiring coverage of the oral medicines on their use in preference to other treatments. Mr. Price also discussed the issue of patient noncompliance with dosage administration when using oral anti-cancer medications, and the benefits accruing to pharmaceutical companies under the bill. Mr. Price then discussed rising drug costs, as identified in Attachment D. Mr. Price responded to questions regarding doctors' preference for oral anti-cancer medicines over intravenous treatments.

12:20 PM -- Ms. Susan Cox and Mr. Jared Freml, representing Kaiser Permanente, testified in opposition to the bill. Committee members received a price sheet for cancer drugs offered by Kaiser (Attachment E), an expert opinion by Dr. Uwe Christians pertaining to Senate Bill 09-250 (Attachment F), and a letter to Ms. Cox pertaining to the side effects of oral anti-cancer medications (Attachment G). Ms. Cox discussed Kaiser Permanente's scope of work, and the impact of the bill on health care costs. Ms. Cox also compared costs for oral cancer treatments to other forms of treatment, and other costs associated with cancer treatment.

12:30 PM

Ms. Cox discussed the information contained in Dr. Christians' expert opinion found in Attachment F. Ms. Cox then discussed the drivers of increased health care costs, and the issue of patient dosage noncompliance when using oral medications. Ms. Cox also discussed the impact of similar legislation in Oregon. Mr. Freml discussed the effects to the patient of taking oral anti-cancer medications. Mr. Freml responded to questions regarding the inability to treat certain types of cancer with medicines other than the oral treatments. Discussion ensued regarding Kaiser's opposition to Senate Bill 09-250 in light of the fact that it already covers oral anti-cancer treatments.

12:41 PM -- Dr. Stephen Leong, representing himself and his patients as a doctor with the University of Colorado Cancer Center, testified in favor of the bill. Dr. Leong discussed the preference for oral anti-cancer medicines for certain types of cancers due to efficacy, and other reasons for preferring oral anti-cancer medicines. Dr. Leong also discussed the costs associated with oral anti-cancer medicines as compared to other treatments, and patient preference for oral treatments. Dr. Leong responded to questions regarding his experience with patients suffering side effects from the oral anti-cancer treatments, and use of the oral anti-cancer treatments by patients living in rural areas.

12:53 PM

Dr. Leong responded to questions regarding the chemotherapy cycle, how patients who aren't covered for oral treatments might acquire the medicine, and the effectiveness of the oral treatments.

12:55 PM -- Dr. Mercedes Dombi, representing Exempla St. Joseph Hospital, testified in favor of Senate Bill 09-250. Dr. Dombi discussed avenues for patients to acquire noncovered oral anti-cancer medications, and explained the efficacy of various types of anti-cancer treatments.

01:03 PM -- Ms. Stephanie Shulman, representing the Rocky Mountain Cancer Centers Foundation, testified in favor of the bill. Ms. Shulman discussed the conveniences afforded by oral anti-cancer treatments, and the cost impacts on patients deciding to further their cancer treatments.

01:05 PM -- Ms. Dana Dzwonkowski, representing the American Cancer Society, testified in favor of Senate Bill 09-250. Ms. Dzwonkowski discussed the impact of oral anti-cancer medicines on patient quality of life.

01:07 PM -- Ms. Cathy Clayton, representing the National Association of Hispanic Nurses and the Colorado Coalition of Black Nurses, testified in favor of the bill. Ms. Clayton discussed the need to move beyond the issue of cost, and objected to the idea that cancer patients are basing treatment decisions on advertising.

01:10 PM -- Representative Kagan, representing one of his constituents, testified in favor of Senate Bill 09-250. Based on his constituent's experience as a cancer patient, Representative Kagan discussed costs associated with cancer treatment and the limiting aspect of cancer treatment costs on patient choice.

01:14 PM

Discussion ensued regarding the effect of prepared amendment L.011 (Attachment H). Ms. Kristen Forrestal, representing the Office of Legislative Legal Services, provided input on the amendment's effect. Ms. Forrestal responded to questions regarding consideration required of doctors under the amendment as to differing types of cancer treatments. Representative Primavera responded to questions regarding the impact of the amendment on the overall purpose of Senate Bill 09-250. Discussion ensued regarding the effect of the amendment on insurance costs.


BILL:	SB09-250
TIME:	01:14:55 PM
MOVED:	Todd
MOTION:	Moved prepared amendment L.011 (Attachment H). The motion passed on an 11-0 roll call vote.
SECONDED:	McCann
		VOTE
	Casso	Yes
	Court	Yes
	Hullinghorst	Yes
	Lambert	Yes
	Massey	Yes
	McCann	Yes
	Miklosi	Yes
	Murray	Yes
	Nikkel	Yes
	Labuda	Yes
	Todd	Yes

Not Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:24 PM

Representative Primavera provided closing remarks in favor of Senate Bill 09-250.


BILL:	SB09-250
TIME:	01:26:14 PM
MOVED:	Todd
MOTION:	Moved to refer Senate Bill 09-250, as amended, to the Committee on Appropriations with a favorable recommendation. The motion passed on an 8-3 roll call vote.
SECONDED:	Miklosi
		VOTE
	Casso	Yes
	Court	Yes
	Hullinghorst	Yes
	Lambert	No
	Massey	Yes
	McCann	Yes
	Miklosi	Yes
	Murray	Yes
	Nikkel	No
	Labuda	No
	Todd	Yes

Final YES: 8 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS