Cancer Drug Parity Act of 2025

Reduced out-of-pocket costs for oral medications: Group health plans would be required to provide cost-sharing for prescribed, patient-administered anticancer medications that is no less favorable than the cost-sharing for medications administered intravenously or injected by a health care provider (Section 2(a)).

Protection against cost increases: The bill prevents health plans from changing benefits or replacing existing benefits in ways designed to increase out-of-pocket costs or reclassify benefits to increase costs for anticancer medications (Section 2(c)).

Protection against restrictive limitations: Plans are prohibited from applying more restrictive limitations on prescribed oral anticancer medications than on those that are administered intravenously or injected (Section 2(c)).

Data-driven insights for future access: The GAO is required to conduct a study to assess the impact of this law on out-of-pocket costs and provide recommendations to Congress on how to reduce financial barriers to accessing these medications (Section 3).

Existing utilization controls remain: The bill does not prevent group health plans from requiring prior authorization or imposing other appropriate utilization controls when approving coverage for chemotherapy (Section 2(d)).

No requirement for specific medication types: The law does not require a group health plan to use orally administered anticancer medications as a replacement for other anticancer medications (Section 2(d)).