Burton Act of 1946); some state and federal programs provide free cancer screening and sometimes treatment for the uninsured (e.g., the Centers for Disease Control and Prevention [CDC] National Breast and Cervical Cancer Early Detection Program; the Maryland state program that pays for treatment for uninsured women with breast cancer); at least 50 pharmaceutical companies have patient assistance programs to help defray the costs of expensive chemotherapy drugs for those who are poor and uninsured (or underinsured);1 and some charitable organizations provide free services or financial assistance to individuals with cancer. These programs and services cannot substitute for adequate insurance coverage for cancer treatment, but they can ease the financial burden for those who receive them.

  • The American Cancer Society has a volunteer-based program called Road to Recovery that provides transportation for cancer patients to and from medical appointments and treatments (Anne Marie Oria, Texas American Cancer Society, personal communication to Elizabeth Kidd, October 1998).
  • Cancer Care, a nonprofit, voluntary agency serving primarily the New York City area provides, on a limited basis, financial assistance for treatment-related expenses (e.g., transportation, child care, home care, pain medication) (Sherry Fremont, personal communication to Elizabeth Kidd, October 1998).
  • St. Jude Children's Research Hospital provides free medical care, transportation, and other supportive services for children with cancer and other conditions (Jerry Chipman, personal communication to Elizabeth Kidd, September 1998).
  • The Organ Transplant Fund provides health care support services, financial assistance, and advocacy programs to transplant candidates and their families (Organ Transplant Fund, 1998).

At least 27 states sell comprehensive health insurance to state residents with serious medical conditions who cannot find a company to insure them or who cannot afford the high cost of coverage. The insurance provided through these so-called state risk pools (also known as Guaranteed Access Programs) generally costs more than regular insurance, and in some states, there are waiting periods for coverage of preexisting conditions and lifetime caps on benefits (e.g., sometimes as low as $250,000) (Matt Hayes, Patient Advocate Foundation, personal communication to Elizabeth Kidd, September 1998).


Bristol-Myers Squibb Company, for example, provides financial assistance to pay for the near 25 chemotherapy drugs that it makes. One of its products, Vepesid, (etoposide, oral), could cost an uninsured (or underinsured) cancer patient more than $1,000 per month. This program approved more than 5,000 applications from January through September 1998 (individuals must reapply for assistance every six months) (Betsey Grasser, personal communication to Elizabeth Kidd, October 1998). The Bristol-Myers Squibb program and those of other pharmaceutical companies have stringent eligibility requirements based on income and insurance status.

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