Washington, D.C., —Today the president is expected to announce American Patients First, a series of proposed policy solutions aimed at reducing the rising costs of prescription drugs. Proposals expected to be announced include various changes to Medicare’s prescription drug program, such as protecting beneficiaries from catastrophic costs through an out-of-pocket maximum, and requiring plans to share a minimum portion of drug rebates with patients.
Administration officials have also referenced greater benefit design flexibility as a mechanism to bring down costs.
A statement from Chris Hansen, President of the American Cancer Society Cancer Action Network (ACS CAN) follows:
“Cancer patients rely on prescription drugs to treat, survive and recover from their disease. Promising new therapies have improved cancer patients’ survival, yet increasingly patients are struggling with unaffordable out-of-pocket costs. Because cancer risk increases with age, the proposed Medicare changes anticipated today have the potential to impact many cancer patients and survivors.
“Limiting catastrophic out-of-pocket costs, sharing rebates with patients and improving formulary transparency could collectively reduce financial vulnerability that too often forces seniors to choose between lifesaving care and their lifesavings.
“However, providing benefit design flexibility – while potentially leading to lower up-front costs – could result in long-term financial challenges for patients with serious conditions like cancer, who could end up footing the bill if their particular cancer drug is not included on the plan’s formulary. With more than 200 different cancers with a tremendous range of therapies to address the heterogeneous nature of the various types of the disease, it is imperative that those facing a cancer diagnosis have access to evidence-based therapies.
“ACS CAN supports proposals that balance innovation with affordability including those that cap out-of-pocket drug costs for patients, and improve the transparency and patient understanding of prescription drug coverage including the list of drugs covered under a medical benefit, the cost sharing, and any utilization management tools.
“While we appreciate the administration’s commitment and support reform that won’t have unintended consequences that erect barriers to evidence-based drug therapies, it is important to evaluate prescription drug affordability as one cost driver in our complex health care system. Keeping health care affordable for cancer patients and other Americans requires a comprehensive examination of all cost drivers. ACS CAN will continue its advocacy efforts to ensure patients have access to quality, affordable health care coverage for all their needs, including prescription drugs.
“We welcome a dialogue with the administration and other policymakers on this issue that is critical to those with a history of cancer, because too often affordability can be a barrier to accessing care. ACS CAN looks forward to the opportunity to review specific policy details as they become available and will provide patient perspective on the real-world impact of these proposals on those families affected by cancer."