SCLD Update
Year In Review

Breast Cancer Detection
Cervical Cancer Detection
Ovarian Cancer Detection
Prostate Cancer Detection
Testicular Cancer Detection
Cancer-General
Tobacco-Use Reduction
State-of-the-Art Treatment
Cancer Registries
Addendum
Enacted Legislation and Adopted Resolutions

State-of-the-Art Treatment

Louisiana passed legislation (S.B. 722) prohibiting specified individual and group insurers, including HMOs and PPOs, that cover the treatment of cancer from excluding coverage for the off-label use of drugs to treat cancer. To qualify, a drug must be recognized for the treatment of the indicated cancer in: (1) the United States Pharmacopoeia Drug Information, (2) the American Hospital Formulary Service Drug Information, or (3) substantially accepted peer- reviewed scientific studies published in a journal specified by the U.S. Department of Health and Human Services. Coverage also must include all medically necessary services which are associated with the administration of the drug. Insurers are not required to cover drugs or services furnished without charge to participants in research trials, nor drugs determined by the Food and Drug Administration (FDA) to be contraindicated.

In Oregon, S.B. 312 prohibits insurers that provide coverage for prescription drugs from excluding coverage for the off-label use of such drugs. The drug must be recognized as effective for the treatment of that indication by the state Health Resources Commission ("Commission"), relying on the following: (1) publications that the Commission determines to be equivalent to the American Hospital Formulary Services drug information, Drug Facts and Comparisons, the United States Pharmacopoeia drug information, or other publications that have been identified by the U.S. Secretary of Health and Human Services ("Secretary") as authoritative; (2) the majority of peer-reviewed literature; or (3) the Secretary. Required coverage includes medically necessary services associated with the administration of the drug. However, coverage is not required for drugs that the FDA has determined to be contraindicated, nor for experimental drugs not approved for any indication by the FDA.

Clinical Trials

Rhode Island enacted two measures (H.B. 5062 and S.B. 1) that require specified individual and group insurers, including HMOs, to provide coverage for Phase II clinical trials for new therapies still under investigation. The coverage supplements customary funding provided by government agencies and commercial organizations. The final version of the law is effective January 1, 1998, through December 31, 1999.