Medicare cuts threaten access to lifesaving cancer treatments

By | October 7, 2018

A cancer diagnosis is a life-changing event. It triggers a series of decisions a patient and their family must make, often in rapid succession. A key determination is where to get and how to pay for care.

As CEO and Director of the University of New Mexico Comprehensive Cancer Center, or UNMCCC, I see my patients and colleagues struggle with these choices every day. It is particularly challenging when your patient lacks the security of insurance. Slightly more than half of our patients are racial and ethnic minorities, more than half are from medically underserved rural counties and American Indian Nations with high rates of poverty and cancer health disparities, and 13 percent are uninsured. As a National Cancer Institute Designated Comprehensive Cancer Center, we work to make sure all patients have access to care and clinical trials no matter their ability to pay.

Aracely was one of those patients. Diagnosed with advanced-stage breast cancer in Gallup, at the southeastern border of the Navajo Nation, Aracely was turned away from a private healthcare provider who deemed her insurance inadequate. But she was determined to survive. Aracely and her family drove back and forth to us in Albuquerque — a three-hour drive away — for months to receive lifesaving cancer surgery, chemotherapy, and radiation treatment. Today, Aracely is cancer-free. But our mission, to assure that all New Mexicans have access to state-of-the-art care and benefit from advances in cancer research, regardless of their health insurance and socioeconomic status, is in serious jeopardy.

For more than 25 years, the federal 340B drug pricing program has been critical in our ability to care for disadvantaged patients. This congressionally-mandated program requires pharmaceutical manufacturers to sell medications at discounted prices to qualified healthcare providers, partially shielding them from skyrocketing drug prices while strengthening their ability to develop comprehensive clinical programs for underserved populations. The 340B program has led to better health outcomes at lower costs for vulnerable patients and the safety-net hospitals that treat them and doesn’t cost the American taxpayer a dollar. Preserving the 340B drug pricing program is vital to ensuring that affordable lifesaving drugs are within reach for all patients.

The 340B program saves our center over $ 10 million per year in drug costs. Just as Congress intended, we reinvest these savings in cancer treatment, research, teaching, and community outreach programs that ensure that New Mexicans have equal access to the quality of cancer care that all Americans deserve.

Earlier this year, we were among dozens of cancer centers, hospitals, and healthcare systems across the country hit with a major funding cut. The Centers for Medicare & Medicaid Services slashed Medicare reimbursement rates for the purchase of the vast majority of lifesaving cancer drugs by nearly 30 percent, effectively wiping out the benefit of the 340B program that Congress intended. To sustain our clinical mission, we were forced to eliminate a large number of staff; slow or suspend the recruitment of critical cancer physicians and scientists; and cut back on education, training, and community outreach programs.

CMS implemented the $ 1.6 billion cut despite strong bipartisan objections from Congress, the Association of American Cancer Institutes, the American Association of Medical Colleges, the American Hospital Association, and directors of academic cancer centers. Recently, CMS announced plans to continue these cuts into 2019 and to extend them to include certain 340B hospital outpatient clinics that were exempt this year.

National hospital associations are suing in federal court to halt the CMS cuts. In the U.S. House, bipartisan legislation introduced by Reps. David McKinley, R-W.Va., and Mike Thompson, D-Calif., has 200 sponsors. And Rep. Doris Matsui’s, D-Calif., SERV Communities Act would reverse the cuts and require transparency from drug companies that set medication prices.

This would be a great time for Congress to put partisanship aside and act to support a program that plays a key role in preserving the healthcare safety net for those who need it.

Cheryl L. Willman, M.D., is CEO and Director of the University of New Mexico Comprehensive Cancer Center, an internationally-known leukemia researcher, and an expert in cancer genomics, precision medicine, and cancer health disparities.

Healthcare