Proposed Medicare Reimbursement Cut for Cancer Care Drugs as Part of Deficit-Reduction Plan Would Lead to Reduced Services, Closures for Community Cancer Centers
WASHINGTON – In a letter sent to Congressional Leadership and the White House today, ten leading patient advocacy groups, community cancer care providers and healthcare professional organizations urged lawmakers to oppose a $3 billion funding cut to Medicare reimbursement for cancer-fighting drugs that, if enacted, would lead to facility closures, barriers to patient access to cancer care and significant healthcare job losses.
The measure, proposed as part of ongoing deficit-reduction talks geared toward raising the national debt ceiling, would affect reimbursement for cancer drugs and biologics by lowering Medicare reimbursement for Part B drugs to Average Sales Price (ASP) plus 4 percent – a reduction that already financially strained community cancer centers cannot endure without cutting vital care services or closing altogether.
“State-of-the-art, community-based cancer centers provide treatment to more than 80 percent of our nation’s cancer patients, who depend upon having this access to quality, accessible care in their local communities,” said Leonard Kalman, M.D., Chairman of the Public Policy Steering Committee of The US Oncology Network. “This latest proposed cut will be debilitating to community-based cancer care practices who are already grappling with significant cuts to reimbursement for chemotherapy drugs and services.”
According to the American Cancer Society (ACS), more than 1.5 million new cancer cases are expected to be diagnosed this year. Community cancer care practices offer unique value to patients by providing integrated clinical care services close to patients’ homes, friends and family. According to a recent study by the Community Oncology Alliance (COA), over the past three years nearly 200 cancer clinics have closed, and 369 practices with multiple locations are struggling financially due to existing reimbursement and administrative burdens.
In the letter, the organizations wrote:
The cumulative effect of these cuts is compounded by the fact that chemotherapy agents are reimbursed at artificially low rates under Medicare because manufacturer-to-distributor prompt pay discounts are included in the calculation of Average Sales Price (ASP). In recognition of the dire financial reality currently facing community oncology practices and the access impact to Medicare beneficiaries fighting cancer, more than 80 bipartisan Congressional leaders have co-sponsored HR 905 (Whitfield/Green) and S 733 (Stabenow/Roberts) to improve the viability of community cancer care. The cuts currently under consideration take the exact opposite direction from the changes these leaders recognize must be made to preserve the nation’s cancer care delivery system.
“We understand the immense challenge before Congress and the President in raising the debt ceiling. However, forcing cancer patients to travel longer distances for their care – often leading to duplicative and unnecessary services, additional co-pays, and physical and emotional suffering – should be off the table for cuts,” added Dr. Kalman. “We urge Congress to work with us to protect the nation’s cancer care delivery system, not weaken it with these truly dangerous funding cuts.”
Letter signatories include the American Society for Clinical Oncology (ASCO), Community Oncology Alliance (COA), The US Oncology Network, Association of Community Cancer Centers (ACCC), National Coalition for Cancer Survivorship (NCCS), National Patient Advocate Foundation (NPAF), Healthcare Distribution Management Association (HDMA), UPMC Cancer Centers, Amerisource Bergenand McKesson Corporation.