Governor Steve Bullock traveled to Bozeman this morning to sign Senate Bill 55, Senator Christine Kaufmann's bill to require insurance coverage for patients participating in clinical trials.
The new law increases access for Montana cancer patients to cutting-edge treatment without concern for whether their insurance will cover the cost of their basic care.
The Governor joined Kaufmann, Rep. Kathleen Williams and Bozeman Deaconess Cancer Center oncologist Jack Hensold, MD, for a ceremony at the center. Dr. Hensold has worked tirelessly to ensure that the cost of standard care for a cancer patient in a clinical trial would be covered by their insurer. Costs for experimental drugs being tested in trials are covered by trial sponsors. Insurers had mistakenly thought they were being asked to pay for these new treatments.
"I want to thank everyone who supported this very important bill, especially the patients who came to the Capitol to tell their stories of the battle to gain access to clinical trials," Bullock said. "Cancer patients should be able to focus all their energy on getting well -- not having to fight with insurance companies over who is footing the bill for their basic care."
A letter from Whitefish cancer patient Jennifer Burrough, who agreed to share her experience with trying to get insurance to participate in a clinical trial, follows:
Letter from Jennifer Burrough:
I would like to extend my sincere appreciation for the work surrounding Senate Bill 55 and its recent passing. It has affected me firsthand in the following way:
I was diagnosed with Chronic Myeloid Leukemia (CML) about one month ago. As you can imagine, the diagnosis was shocking and emotional. I am 42 years old, and a wife and mother of three children, ages 12, 10 and 7. I decided to see a CML specialist at MD Anderson Cancer Center in Houston to confirm the diagnosis and
explore the latest treatment options. My doctor at MD Anderson, Jorge Cortes invited me to participate in a clinical trial for the new drug ponatinib. It is a third generation oral chemotherapy drug that is showing incredibly promising results for long-term remission of CML. It has the highest response rate of any drugs in its class, which of course made me want it.
MD Anderson's initial request for prior authorization of services related to the clinical trial was denied by Blue Cross Blue Shield of MT, due to an exclusion clause in my insurance contract that denied services related to any drug or device that was considered experimental or investigational, or that was in any phase of clinical trial.
I was discouraged and frustrated to know that I was being denied access to the latest and potentially best treatment available to me. I was prepared to "settle" for the next best option, when a close friend encouraged me to pursue an appeal. I quickly contacted the Montana Commissioner of Securities and Insurance office and filed a complaint. Meanwhile, we discovered House Bill 615 and subsequent Senate Bill 55, which had been signed into law by Governor Bullock only weeks before. It seemed to be a perfect fit for my situation. We continued to pursue it, and last Friday, after three denials and multiple conversations with many people from many organizations, I received a phone call from Mary Belcher of Blue Cross Blue Shield of Montana reversing their previous decision, and approving coverage for routine care related to the clinical trial MD Anderson suggested for me. I will be starting the trial medication this week.
I am incredibly grateful for everyone who worked to make this bill a reality. Your efforts have given me and many other cancer patients in Montana access to cutting edge treatments and protocols, thereby increasing the odds of successful response and allowing each family to choose the treatment that best suits them. In addition, your work will further the research efforts of renowned cancer organizations around the world.
I am also thankful to everyone who helped me navigate this process, first and foremost my friend Diana who gave me the encouragement and practical help to fight for approval. After reading the new law, she would simply not give up until this law was applied to my case. I appreciate everyone who worked together in a timely fashion to apply this legislation for the first time: Rep. Kathleen Williams, the sponsor of the bill, Mary Belcher from Blue Cross Blue Shield of Montana, Ron Herman at the Commissioner of Securities and Insurance, Kristin Page Nei at the Cancer Society of Montana, and the people behind the scenes whose identity I don't know. I appreciate that Governor Steve Bullock signed this bill into law. I hope that through the process of getting my case approved, we will help to clarify the language and work out the kinks for the next cases to come.