Sep 18, 2023
News & Updates : Press Releases
New Bicameral Bill Protects Cancer Care Providers and Preserves Patient Access to Important Medications
The Community Oncology Alliance (COA) supports the Protecting Patient Access to Cancer and Complex Therapies Act (S. 2764, H.R. 5391), a key piece of legislation that ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers.
Introduced by U.S. Senator John Barrasso (R-WY), U.S. Representative Michael Burgess (R-TX) and U.S. Representative Greg Murphy (R-NC), the Protecting Patient Access to Cancer and Complex Therapies Act provides a technical fix to a key provision of the drug pricing negotiations in the Inflation Reduction Act (IRA). As the IRA is currently written, the Medicare reimbursement rate for negotiated drugs will be based on the Maximum Fair Price (MFP) negotiated by the Centers for Medicare and Medicaid Services (CMS) plus six percent, rather than the standard Average Sales Price (ASP) plus six percent.
Basing reimbursement on the MFP will drastically cut reimbursement for Part B drugs, hindering the ability of community oncology practices to administer drugs and keep their doors open. An analysis conducted by Avalere Health found that the IRA would lead to a minimum 49.5 percent Part B reimbursement cut for providers, an unsustainable and irresponsible cut for those treating cancer and other potentially life-threatening diseases. Making this technical fix to how drug price negotiations are implemented in the IRA is crucial to the survival of our nation’s cancer care system. When practices close, it becomes harder for patients to access lifesaving medications, either having to travel farther to receive treatment or seeking it in the more expensive hospital setting.
These cuts follow 10 years of destructive Medicare payment cuts for community oncology practices. A new analysis demonstrates that from 2014 to 2023, Medicare reimbursement for independent oncology procedures declined by 5.4 percent, while medical inflation increased by 28.4 percent, creating an effective cut in reimbursement by 33.8 percent. Continuing to reduce reimbursement for vital procedures and drugs will put quality cancer care out of reach for most Americans.
The Protecting Patient Access to Cancer and Complex Therapies Act will preserve the current reimbursement structure for providers by having drug manufacturers directly rebate Medicare for the lower negotiated rate. This technical fix removes providers and patients from the middle of price negotiations and is budget neutral.
COA applauds the leadership of Senator Barrasso and Representatives Burgess and Murphy. As physicians, they understand the destructive nature of putting physicians in the middle of these drug pricing negotiations. COA calls on all members of Congress in the Senate and House to cosponsor this very important legislation. Passing the Protecting Patient Access to Cancer and Complex Therapies Act into law is a huge step toward preserving the nation’s cancer and critical care providers.