Webinar Recap: The Impact of 340B Reimbursement Cuts on AACI Cancer Centers

Since the Centers for Medicare and Medicaid Services (CMS) reimbursement cuts to the 340B drug pricing program went into effect January 1, AACI has been advocating to protect the program. CMS slashed what Medicare pays 340B hospitals for many oncology infusions and other physician-administered drugs, reducing reimbursement rates by nearly 30 percent. As a result, several AACI cancer centers have eliminated jobs, suspended faculty recruitment, and cut back on important educational programming. Among those hit hardest by the cuts are cancer centers and safety-net hospitals that care for low-income and rural patients, compounding cancer health disparities in the U.S.

As a continuation of its ongoing advocacy efforts, AACI hosted a webinar on Friday, September 14, titled “The Impact of 340B Reimbursement Cuts on AACI Cancer Centers.” Featured presenters were Jeff Davis, senior advisor and of counsel at Baker Donelson; Cheryl L. Willman, MD, CEO and director of University of New Mexico Comprehensive Cancer Center (UNMCCC); and Sandra F. Durley, PharmD, senior associate director of ambulatory care pharmacy services at UI Health. AACI Deputy Director Jennifer Pegher moderated the webinar.

Following a detailed overview of the 340B program and its original intent from Mr. Davis, Dr. Willman described the negative repercussions of 340B program cuts she has already encountered at the UNMCCC.

“The excellent outcomes that we desire for our patients require access to clinical trials and many new cancer treatment modalities,” said Dr. Willman. “These include precision medicine, genome sequencing, targeted therapies, immunotherapies, and new experimental therapies – often of an exceedingly high cost.”

Through robust data, Dr. Durley described the financial impact on UI Health, where, she pointed out, oncology-related purchases accounted for 52 percent of 340B spending in Fiscal Year 2018.

She also shared moving patient stories, including that of I.H., an uninsured 30-year-old-man who was able to receive $5,700 worth of medication to treat acute myeloid leukemia for only $20, thanks to 340B discounts and the Medication Assistance Program.

“I wanted nothing more than to get well,” I.H. said. And he did: I.H. is still in remission today.

More than 80 participants—including cancer center directors, administrators, finance officers, and clinical trials office managers—tuned in to the webinar, which is just one facet of AACI’s advocacy efforts to preserve the 340B program.

AACI is still collecting responses to its 340B Impact Survey. And we encourage member centers to participate in our advocacy efforts by writing op-eds, contacting their state’s Senators and Congressional representatives, sharing social media posts using the hashtag #Protect340B, and submitting their comments to CMS by Monday, September 24. Please contact AACI for sample op-eds and supplemental educational resources on the program.

Download the webinar slides.
Download the audio recording.

Pictured (left to right): Jeff Davis, Dr. Cheryl L. Willman, Dr. Sandra F. Durley  

 

 

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CMS Reimbursement Cuts to Cancer Centers Threaten Access to Lifesaving Cancer Treatments for Underserved Patients

Willman

Cheryl L. Willman, MD

On January 1, 2018, the Centers for Medicare & Medicaid Services (CMS) implemented a new rule that significantly reduces reimbursement to hospitals and the vast majority of cancer centers that participate in the Congressionally-mandated 340B Drug Purchasing Program. The new CMS rule (82 FR 52356) went into effect without Congressional approval and despite strong bipartisan objections from legislators in both chambers of Congress, the Association of American Cancer Institutes (AACI), and a large majority of cancer center directors from NCI-designated and emerging academic cancer centers. The rule disproportionately harms those hospitals and cancer centers that provide care for the most vulnerable and underserved cancer patients, compounding the nation’s tremendous cancer health disparities.

Established by Congress in 1992 with strong bipartisan support, the 340B Drug Pricing Program requires drug manufacturers to sell drugs at discounted prices to hospitals and cancer centers that provide a disproportionate share of care to low-income, rural, poor, and underserved patients, to have their drugs covered by Medicare and Medicaid. The Congressional intent of the 340B Drug Pricing program is to allow hospitals and cancer centers to reinvest their savings from these drug discounts to assure patient access to high-quality care and lifesaving cancer treatments, and to develop comprehensive services.

The new CMS rule drastically reduces Medicare Part B reimbursement rates for drug  purchases to hospitals and cancer centers participating in the 340B Drug Pricing Program. Under the new rule, CMS reimbursement for drug purchases has decreased from the prior rate of Average Sale Price (ASP) plus 6 percent, to ASP minus 22.5 percent, resulting in a cut of $1.6 billion per year to the nation’s public safety-net hospitals and cancer centers. This cut fully eliminates the benefit of the 340B drug pricing program to participating cancer centers. Despite claims by CMS and the drug industry, the new rule does not lower drug prices, save money for Medicare or for seniors, or reduce patient co-pays. In fact, the cost of lifesaving cancer drugs is predicted to increase significantly.


Read more from Dr. Willman, CEO and director of the University of New Mexico’s Comprehensive Cancer Center, in AACI’s July 2018 Commentary

AACI Supports NCI Clinical Trials Awareness Campaign

In keeping with Vice President Biden’s Cancer Moonshot goal to expand patient access to new cancer therapies via clinical trials, the Association of American Cancer Institutes (AACI) looks forward to working with the National Cancer Institute (NCI) to increase awareness of NCI-supported clinical trials. We encourage AACI centers to explore novel tools, such as the new application programming interface available from the NCI, to help physicians and patients find information about NCI-supported clinical trials, moving us closer to our shared goal of maximizing patient opportunities to participate in clinical trials.

Read more here:

FACT SHEET: Vice President Biden Announces New Steps to Improve Clinical Trials Essential to Advancing the Cancer Moonshot (The White House)

We Are All Part of the Cancer Moonshot: Vice President Biden on Why Everyone’s Participation in Clinical Trials Matters  (The official Medium account of the Vice President’s Cancer Moonshot)

Meeting Patients Where They Are: Liberating Clinical Trials Data Under the Cancer Moonshot  (NCI Cancer Currents blog)

AACI Endorses Blue Ribbon Panel Recommendations

The Association of American Cancer Institutes (AACI) strongly supports recommendations issued today by the Cancer Moonshot Blue Ribbon Panel, and thanks the panel’s members who lead AACI cancer centers for their service to the cancer research community.

At the request of the White House, under the leadership of Vice President Joe Biden, the Blue Ribbon Panel has produced a report outlining areas of urgent action to speed progress in the field of cancer research. brp-report-cover

The panel, comprised of scientific experts, cancer leaders, and patient advocates, includes four AACI cancer center directors: Mary Beckerle, PhD,CEO and Director, Huntsman Cancer Institute, Salt Lake City; Chi Van Dang, MD, PhD, Professor of Medicine and Director, Abramson Cancer Center, University of Pennsylvania, Philadelphia; Augusto Ochoa, MD, Professor of Pediatrics and Director, Stanley S. Scott Cancer Center Louisiana State University, New Orleans; and, Jennifer Pietenpol, PhD, Professor of Oncology, Professor of Biochemistry, and Director, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee. In addition, Laurie Glimcher, MD, Professor of Medicine and Dean, Weill Cornell Medical College, is incoming President and CEO, Dana-Farber Cancer Institute, Boston.

The report’s recommendations include a focus on areas where we are poised to accelerate scientific progress as well as patient involvement, developing a “national cancer ecosystem” and working together to share data and results more effectively.

“As a primary source for the generation, collection and use of molecular, clinical and outcomes data, AACI and its member cancer centers fully support the Blue Ribbon Panel’s call to revolutionize the generation and sharing of medical and research data,” said AACI President George J. Weiner, MD.

Dr. Weiner stressed that steady, predictable funding for the National Institutes of Health and the National Cancer Institute is vital as cancer centers work to share data and improve information systems and communication across the cancer continuum. Streamlining regulatory oversight of these efforts, while also protecting patient privacy, is central to optimizing progress.

A key element of AACI’s mission is helping cancer centers keep pace with the changing landscape in science, technology and health care. The Blue Ribbon Panel report notes that “the vast majority of Americans do not have easy access to precision cancer testing since oncology clinical trials are offered mainly at large academic cancer centers and not at community cancer centers where most cancer patients receive their treatments.” In July, AACI presented a white paper to the Office of the Vice President detailing AACI President-Elect Stanton L. Gerson, MD’s presidential initiative to include the academic cancer centers as the focal point for broader community access. The white paper focused on the deep impact AACI centers have on cancer care and novel therapy through clinical trials.

“AACI looks forward to collaborating with the members of the Blue Ribbon Panel in order to implement their important recommendations and to meet the Vice President’s goal of ending cancer as we know it,” said AACI Executive Director Barbara Duffy Stewart, MPH.