Investigation

Report about mother with cancer could help pass new law

Senator proposing bill to force insurance to pay for cancer drugs

CREATED Feb. 5, 2013

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  • Your state Senator ... vowing to take action to help Southwest Floridians like this cancer-stricken mother, struggling to stay alive for her kids. What happens when the medicine you need to live gets so expensive you can't afford it? Video by fox4now.com

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LEE COUNTY - Your state Senator ... vowing to take action to help Southwest Floridians like this  cancer-stricken mother, struggling to stay alive for her kids. What happens when the medicine you need to live gets so expensive you can't afford it?
 
Dawn Beagles found out the hard way when her med co-payment shot up by 2,000%. Four in your Corner investigator Mike Mason got her the help she need. Tonight he's working to get you help if your family is ever in the same situation. 
 
Cancer groups and a local senator are spear-heading a bill to make these life saving drugs available to *all* cancer patients. They're hoping Dawn's story will show lawmakers how insurance companies are being allowed to pick and choose which drugs they want to cover.
 
When Stefanie Steele saw our report about dawn beagles, she wanted to help.
 
Stefanie Steele: "I thought, ‘this is exactly what we're seeing across the state’."
 
Steele is Executive Director for Susan G. Komen in Orlando. Komen and other cancer groups are working to help folks like Dawn.
 
Two weeks ago....Dawn turned to us for help. After she was diagnosed with brain cancer last year, her doctor prescribed her the chemo drug Temodar. At that time her copayment was only $30 a month but on January 1st it jumped to $660 per month, and with all the other medications she's taking she couldn't afford it.
 
Dawn says her insurance company, United Healthcare, pays for Temodar in I-V form but if she wants to take the pills instead, she has to pay $660 a month. That means for one full year...Dawn would have to go to a hospital....each day....to receive her chemotherapy intravenously...even though her doctor says the pill form is better for her. Steele says for many insurance companies this is common practice.
 
Stefanie Steele: "So when you go for your IV treatment you just have an office co-pay, $20, $30, $50 dollars. However if you are prescribed one of these oral drugs you're then under the pharmacy benefit which costs you sometimes thousands of dollars a month."
 
Florida Senator Lizbeth Benacquisto is spearheading a bill aimed at leveling the playing field. Next month she'll introduce the bill to lawmakers....asking insurance companies to pay for cancer drugs equally, regardless of whether they're in I-V or pill form.
 
Senator Lizbeth Benacquisto: "It's really unfortunate that when someone has to make a lifesaving decision that they can't take the medication that their doctor feels is the best choice for them."
 
Dawn was lucky. After contacting us we worked with Merck - the company that makes Temodar - they made an exception for Dawn, agreeing to provide her medication free of charge.
 
Dawn Beagles: "You came and things got resolved so it was really a good thing."
 
Rob Raines: "We went through Channel 4, you guys wanted to hear about it, you wanted to do the story."
 
But Benacquisto knows many out there are not so lucky. She'll share Dawn's story with lawmakers in hopes of convincing them to approve the new bill and improve the lives of those battling cancer.
 
Senator Lizbeth Benacquisto: "I would just say to Dawn and all the folks like her who are dealing with this very difficult disease and this very difficult decision to know that there are people out there who care about what they are going through and are looking to make it right."
21 other states have already adopted a bill requiring insurance companies to pay for cancer drugs equally.
When Benacquisto's bill is introduced to lawmakers next month we'll let you know how it turns out. If you have story like Dawn Beagles’ and want to share it with lawmakers to ensure this legislation is passed, please email: cancercareaccess@gmail.com.