Amendment Would Make Simple Fix to Remove Providers from Middle of Drug Price Negotiations in Reconciliation Bill That Threatens Practices

Statement from Ted Okon, Executive Director, COA

The Community Oncology Alliance (COA) strongly supports the proposed amendment from United States Senator John Barrasso (R-WY) to fix the fundamentally flawed proposed Prescription Drug Pricing Reform provisions in the reconciliation bill.

Sen. Barrasso’s relatively simple fix takes providers out of the middle of negotiations between the government and drug manufacturers. Instead, drug manufacturers will directly refund the government excess costs above negotiated prices. There is already a precedent for manufacturers to rebate the government in the way the amendment proposes, and it does not put physicians in the middle, exposed to untenable financial cuts and risk from being reimbursed at much lower negotiated rates relative to the underlying costs of drugs.

Independent community oncology practices, as well as other specialty medical practices treating serious diseases, are currently facing unprecedented pressures that threaten their abilities to continue caring for patients. This includes ongoing increased costs due to COVID, severe inflation, and the reintroduction of sequester cuts. Additionally, the Centers for Medicare & Medicaid Services (CMS) has proposed a severe cut to payments in the proposed Medicare Physician Fee Schedule for calendar year 2023. Congress should act to ensure that our health care system is not made even more unstable by adopting Sen. Barrasso’s amendment to fixing the reconciliation bill.

As COA has noted, bluntly cutting Medicare payments like proposed in the reconciliation bill, will lead to cancer practice closures and consolidations. Following the last major overhaul of payment with the Medicare Modernization Act of 2003, the chemotherapy delivered by independent community oncology practices declined by 64.3%. In subsequent years, 1,748 community oncology clinics and/or practices have closed, been acquired by hospitals, undergone corporate mergers, or reported that they are struggling financially. When community oncology practices close, the care almost always moves into hospitals, which are much more expensive settings. Access to care is also threatened as cancer clinics and other specialty facilities close, especially in rural areas, due to financial pressures.

Sen. Barrasso’s amendment is a relatively simple fix that still allows the government to achieve cost savings goals from prescription drug pricing reform while not unnecessarily threatening providers. COA strongly supports the amendment and calls on Congress to adopt it before passing the final reconciliation bill.

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About the Community Oncology Alliance: COA is a non-profit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology where the majority of Americans with cancer are treated. The mission of COA is to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities. More than 5,000 people in the United States are diagnosed with cancer every day and deaths from the disease have been steadily declining due to earlier detection, diagnosis, and treatment. Learn more at www.CommunityOncology.org.  Follow COA on Twitter at www.twitter.com/oncologyCOA or on Facebook at www.facebook.com/CommunityOncologyAlliance.