Breast cancer is among the most common cancer diagnoses in Rhode Island, making up about 13% of diagnoses each year as well as 7% of all cancer deaths.
Early detection can make a difference. South Kingstown Democratic Rep. Kathleen Fogarty is sponsoring a bill that she hopes will make mammograms, which can help with early detection, more accessible and affordable by prohibiting insurers from levying out-of-pocket costs for the diagnostic tests.
“Breast cancer is the most commonly diagnosed and leading killer of Black women,” Fogarty said. “Despite a lower incidence rate, Black women have a 38% higher mortality rate than white women, which I think is just disgraceful. So we really need to help out all women.”
According to the state health department, more than 91% of women diagnosed with breast cancer for the first time live at least five years after being diagnosed.
Fogarty knows firsthand the value of early detection.
“I will share with you that I was just diagnosed with early uterine cancer, and I am actually going in tomorrow for surgery,” Fogarty told the crowd gathered in the State House Library on Tuesday. “So when doctors tell you, if you have any bleeding in your postmenopausal, make sure you go back to your doctor because that’s what I did.”
Fogarty shared her experiences as a featured speaker at the American Cancer Society’s Cancer Action Network (ACS CAN) advocacy day at the statehouse.
“I had a sister who’s a nurse who stayed on top of me, and hopefully we’re going to get it early enough, but tomorrow I go in for surgery,” Fogarty continued. “I am with all of you in your fight against cancer here in Rhode Island.”
Uterine cancer, when detected early, has a five-year survival rate of 95%, according to the National Cancer Institute. Averaged across different demographics and stages of disease severity, over 80% of diagnosed patients live for at least five years from diagnosis. Still, disparities exist in how cancer is diagnosed and treated, something Fogarty pointed to in her remarks.
The same applies to other forms of cancer, too. Uterine cancer mortality rates, for instance, decreased for decades until rising across all demographic groups, according to a 50-year, population-based analysis published in 2023 in the journal Obstetrics and Gynecology. Non-Hispanic Black and Hispanic women ages 30 to 39 had the highest annual increases, at 3.3% and 3.8% respectively, in uterine cancer mortality from 2001 to 2018, the study noted.
Fogarty’s bill — along with its twin in the Rhode Island Senate, Bill S0197 by Providence Democratic Sen. Sam Zurier, is one of three lobbied for by the American Cancer Society’s Cancer Action Network in Rhode Island this year. The ACS estimates that 7,500 Rhode Islanders will receive cancer diagnoses this year, and it predicts 2,100 people in the state will die from the disease.
“We should be making it easier, not harder, for Rhode Islanders to afford medications, screenings, treatments that they need,” Ryan Timothy Strik, ACS CAN’s government relations director in Rhode Island, said Tuesday.
A third bill, this one from East Providence Democratic Sen. Robert Britto, would essentially force insurance companies to deduct copay assistance payments from patients’ deductibles for medications.
That would help Paul Adam, an American Cancer Society volunteer who told the crowd about his experience with the expensive biologic drugs. Biologics are derived from living organisms and often carry special handling and storage requirements. They have been a major driver of pharmaceutical development in the past two decades, and are used in a variety of hard-to-treat conditions, from cancers to autoimmune disorders like arthritis — an ailment for which Adam said he gets two shots once monthly.
The drugs also tend to be expensive: Adam said his copay is $2,400 until his deductibles are met.
“Fortunately, I’ve been able to benefit from copay assistance, which essentially covers my copay in full,” Adam said. “However, my insurance company stepped in. Without notice, they stopped applying my copay assistance to my deductible, all because it was coming from a third party.”
Drug manufacturers have long offered copay assistance programs to offset the cost of the expensive drugs they manufacture. Insurers have retaliated in recent years by leveraging tools like copay accumulators. A 2024 review in the Journal of Managed Care and Specialty Pharmacy broke it down like this: Under a manufacturer assistance program, an insurer might pay $16,000 and the manufacturer $8,000 for a drug that costs $24,000 a year. With a copay accumulator in place, the cost might be split evenly between the patient, manufacturer and insurer, at $8,000 apiece.
This is the third year Adam has rallied for the bill.
“I find myself with significant medical debt after three years, and more recently, had to go without my medication for six months,” Adam said. “People shouldn’t have to choose between paying their bills, putting food on the table and affording medications or screenings or treatments.”
Cancer doctors have also expressed dissatisfaction with the pharmacy benefit managers (PBMs) used by insurers to dispense and manage prescriptions for specialty drugs like biologics or newer cancer treatments. In a 2024 survey from Oncology News Central, 50% of the oncologists surveyed said they strongly supported legislation that would regulate PBM’s ability to deliver cancer drugs.
All three bills have been heard in committee hearings in their respective chambers as of Tuesday, and all three have been held for further study, as is standard practice for bills when first introduced.
This story was originally published by the Rhode Island Current.
