Legislature(2005 - 2006)BUTROVICH 205
04/28/2006 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES
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SCS CSHB 393 (HES)-INSURANCE FOR COLORECTAL CANCER SCREENING 2:31:37 PM CHAIR DYSON announced SCS CSHB 393(HES) to be up for consideration. EMILY NENON, Alaska Government Relations Director, American Cancer Society, said that she had spoken with committee members and staff in advance to ensure that her testimony would address all of the questions that they might have, but that she would be happy to answer any additional questions that might arise. She said that when Heath Hilyard presented the bill on Wednesday, he talked about the fact that, if colon cancer is identified before symptoms appear, there is a greater than 90 percent survival rate. According to Cancer Facts and Figures 2006, which publishes a five-year average of cancer incident rates, Alaskan women have had the highest colon cancer rate in the nation over the past five years. The rate of colon cancer in Alaskan Native people is nearly double that of the U.S. white population. 2:33:54 PM MS. NENON said that this bill provides guidelines for colon cancer screening. For the general population, anyone over age 50 should be screened, but people are generally not eligible for Medicare until age 65, which leaves a 15-year window of time when screening is recommended but may not be covered by insurance. The Institute of Medicine reports that the death rate from colon cancer could drop by up to 80 percent if a majority of Americans were screened regularly. The current annual expenditure in the United States on colorectal cancer health care costs is $6.5 billion and part of the reason for that is that it is not being identified early enough. The New England Journal of Medicine published an article in July of 2004 called "The Price tag on Progress," that is about chemotherapy for colorectal cancer. It states that "the near doubling of the median survival achieved over the past decade, has been accompanied by a staggering 340 fold increase in drug costs" just for the initial eight weeks of treatment. Assuming a patient continues to receive treatment until the median time to progression, eight months of front-line therapy followed by 4.1 months of Cetuximab and Irinotecan therapy would cost $161,000. 2:37:22 PM CHAIR DYSON said that the issue the committee has to decide is whether or not to mandate that insurance carriers provide this service to their clients between the ages of 50 and 65. MS. NENON said that is correct, and that 18 other states have already taken this action. She recognizes that state government doesn't regulate every insurance plan, but sees it as "a critical piece of the puzzle." The American Cancer Society worked hard to get Medicare coverage for screening added in 2001 and, working with federal employee health benefit plans over the past three years, has increased the number of federal plans that cover the full range of colon cancer screening from 25 to 70 percent. 2:38:37 PM SENATOR OLSON asked how this would decrease the incidence of colorectal cancer among Alaskan Natives, particularly women, when they are dealing with issues such as a lack of clean water and inadequate sewage treatment. MS. NENON responded that DHSS has been working with the Comprehensive Cancer Control (CCC) partnership to form a colorectal cancer joint task force between the Alaska Native Tribal Health consortium and the state's CCC program to consider those issues. They are looking at, among other things, the possibility of sending gastrointestinal doctors from Anchorage to regional hospitals to do mass screenings. SENATOR OLSON asked whether these would be private physicians or doctors from Alaska Native Medical Center (ANMC) and who would be paying for it. MS. NENON responded that it would be a joint effort and they are still working on the funding, but that some doctors in Anchorage have offered to donate their time. They anticipate receiving some regular reimbursement for those procedures. SENATOR OLSON commented that he assumed these physicians would be gastrointestinal internists who have already been trained and are not going out for the experience. MS. NENON replied yes. 2:40:48 PM SENATOR WILKEN said that most of the committee is of an age to consider this issue seriously and commented on an article he read about a month ago in Scientific American about a new digital screening procedure that may replace the existing sigmoidoscopy and colonoscopy within the next 10 years. MS. NENON said that she is looking forward to that. 2:42:23 PM SENATOR WILKEN moved to report SCS CSHB 393(HES) from committee with individual recommendations. SENATOR GREEN said that she did not object, but was indisposed to introduce anything that is a mandate on anyone. CHAIR DYSON agreed that it presents a real concern for him also, particularly when he considers the insurance companies' previous remarks about this matter. SENATOR GREEN commented that, unlike the lower 48 states, when the legislature makes a law in Alaska that impacts private programs and plans, a large part of the state is not impacted by it. CHAIR DYSON announced that without further comment SCS CSHB 393(HES) was reported from committee.