BY JEANETTE FRIEDMAN
FRIDAY, 14 OCTOBER 2011
Under the leadership of two New Jersey Congressmen, Bill Pascrell and Leonard Lance, 61 members of the House of Representatives — 13 Republicans and 48 Democrats — urged the Joint Deficit Reduction Committee not to cut $3 billion to Medicare, a cut designed to prevent reimbursement of medications for cancer and other serious diseases.
Pascrell and Lance sent their letter to Rep. Jeb Hensarling (R-TX) and U.S. Sen. Patty Murray (D-WA), co-chairs of the Joint Committee. Ted Okon, Executive Director of the Community Oncology Alliance applauded the move and said, “Cancer care is in crisis as evidenced by clinic closings and drug shortages and [patients and the system] simply cannot absorb any additional payment cuts.”
In the last two years, prescription drug costs have skyrocketed even for those suffering from everyday ailments. For example a bottle of Nexium, which treats chronic heartburn, once sold under one insurance company drug plan for $30 for 90 pills. Now the co-pay is more than $160 for the same prescription. Under other drug plans, the co-pay for that same prescription rose to more than $640. For people who do not have a drug plan, 90 Nexium pills now cost $1080. Medications for cancer treatment can cost as much at 10 times that amount and more, and at those prices, many will forego treatment and even hospice care, opting instead for the terminal solution.
Text of the letter:
Dear Senator Murray and Congressman Hensarling:
We appreciate the hard work you are doing as a member of the Joint Select Committee on Deficit Reduction and applaud your willingness to tackle the difficult fiscal issues facing our Nation.
However we are very concerned about any discussion to include $3 billion in cuts to Medicare Part B reimbursement for drugs and biologics medicines that fight cancer and other serious diseases. We believe these potential cuts, if enacted, would adversely affect cancer care in the U.S.
As you know, Congress reformed Medicare Part B reimbursement as part of the 2003 Medicare Modernization Act, and payment amounts for drugs and biologicals were then dramatically reduced. Payments are now set using the Medicare Average Sales Price (ASP) system, which includes the actual prices paid by physicians and other drug purchasers.
The Medicare ASP is a market-driven reimbursement mechanism that has driven down Medicare costs. In fact, the Congressional Budget Office estimated that Medicare would save almost $16 billion over 10 years by reducing payments for Part B drugs using the current ASP system compared to the old reimbursement system. The Medicare Payment Advisory Commission (MedPAC) that advises Congress on Medicare matters said that ASP has resulted in, “substantial price savings for Medicare on nearly all drugs and those payment rate changes drove decreased spending.”
Enacting cuts to ASP could also worsen an already troubling access problem, as community oncology practices are already struggling even as demand for cancer care is now starting to exceed the supply of oncologists. According to one report, in the last 3 1/2 years alone, 199 cancer clinics have closed and 369 practices, with multiple clinic locations, are struggling financially. And it is predicted that over the next ten years there will be an oncologist shortage for one in four cancer patients, and enacting $3 billion in cancer cuts will only exacerbate this problem.
The U.S. has the best cancer care delivery system in the world. 84 percent of Americans receive quality, compassionate care in the community cancer setting. It is imperative that Congress continues to ensure that cancer patients across the nation can continue to have access to lifesaving medical treatments.
It is for this reason that we urge you not to sacrifice cancer care while seeking deficit reduction solutions.
Leonard Lance (R-NJ) Bill Pascrell, Jr. (D-NJ)
Patrick Meehan (R-PA Mike Honda (D-CA)
Dennis A. Ross (R-FL) John Barrow (D-GA)
Brian Bilbray(R-CA) Mike Rogers (R-MI)
David B. McKinley (R-WV) Madeleine Z. Bordallo (D-GU)
Tom Latham (R-IA) Jay Inslee (D-WA)
Richard Neal (D-MA) Ted Poe (R-TX)
Ed Pastor (D-AZ) Charles A. Gonzalez (D-TX)
Terri A. Sewell (D-AL) Gregory W. Meeks (D-NY)
Jim McGovern (D-MA) Howard Coble (R-NC)
Lou Barletta (R-PA) Tim Ryan (D-OH)
Ed Markey (D-MA) Niki Tsongas (D-MA)
Emanuel Cleaver (D-MO) Hank Johnson (D-GA)
Judy Chu (D-CA) John W. Olver (D-MA)
Bruce Braley (D-IA) Elton Gallegly (R-CA)
Jackie Speier (D-CA) Barney Frank (D-MA)
Joseph Crowley (D-NY) Andre Carson (D-IN)
Edolphus “Ed” Towns (D-NY) Bob Filner (D-CA)
Susan A. Davis (D-CA) Joe Courtney (D-CT)
Rush Holt (D-NJ) Stephen F. Lynch (D-MA)
Gene Green (D-TX) John Carney (D-DE)
John Tierney (D-MA) Larry Kissell (D-NC)
Doris O. Matsui (D-CA) Lois Capps (D-CA)
William Keating (D-MA) Kay Granger (R-TX)
Linda Sanchez (D-CA) Reid Ribble (R-WI)
Paul Tonko (D-NY) Jim McDermott (D-WA)
Bill Flores (R-TX) Kathy Castor (D-FL)
Diana DeGette (D-CO) Brian Higgins (D-NY)
Barbara Lee (D-CA) John Yarmuth (D-KY)
Tim Bishop (D-NY) Richard B. Nugent (R-FL)
Nan Hayworth, MD (R-NY)