Message from the CPC Chair
Members of Congress are on recess for the next two weeks for their spring in-district work period, so now is an ideal time for you to meet with your elected representative at home. Meeting now with your Member of Congress personalizes—and makes more immediate—issues facing oncology in your community.  While you meet with your Member of Congress at home, ASCO will continue its work with Congressional leaders in both the House and Senate. Our goal is to advance legislative and administrative proposals that:  

• Promote quality cancer care. Pay-for-performance proposals and other similar efforts advancing in CMS and on Capitol Hill must progress in consultation with the oncology community and must build on extensive work that ASCO and others have already undertaken to promote quality cancer care.    
• Provide appropriate payment for cancer care services.  ASCO is working with patient advocates and community oncologists to advance a comprehensive legislative proposal that will recognize and pay for the full range of services that oncologists provide to patients before, during, and after their cancer treatment. 
• Ensure access to chemotherapy drugs.  ASCO is working to advance legislation that provides fair and adequate payment for chemotherapy drugs at the time the service is provided.  

The pace of change in Washington may not be as fast as we would like, but our determination and energy do not waver. You and your patients are uppermost in our thoughts and our efforts. Your energy over the next two weeks will get us closer to our collective goal of achieving good policy that provides high quality care to all cancer patients. 

Contact your Member of Congress’ District Office, or call ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or by e-mail at grassroots@asco.org.  

ASCO Leader Presents at AOHA Meeting
The Administrators in Oncology/Hematology Assembly (AOHA) of the Medical Group Management Association held its 5th Annual Meeting last week in Las Vegas.  Dean Gesme, MD, a community oncologist from Cedar Rapids, Iowa, and past chair of ASCO’s Clinical Practice Committee, spoke at a "Washington Update Panel" about issues facing the oncology community.  

Dr. Gesme provided frank insight into the current political environment in Washington, including fiscal challenges presented by both domestic and international crises, and the impact of this environment on cancer care. He also provided a general overview of several ASCO initiatives, including development of quality improvement tools, legislative initiatives around treatment and survivorship, and work with Congress to assure proper payment for chemotherapy drugs. 

ASCO’s partnership with AOHA has been highly successful, producing tools and information to better navigate tremendous changes in the past few years. It is this kind of partnership—played out each day with doctors, nurses, patients and administrators—that has built the best cancer care system in the world.  ASCO values its relationship with AOHA and looks forward to continuing this important work in the coming weeks and months ahead.   

ASCO and NCCS Urge FDA to Issue Guidance on Expanded Access Programs
In another partnership effort, ASCO and NCCS filed a Citizen Petition with the Food and Drug Administration (FDA) in late March, requesting that the FDA clarify procedures and standards for allowing individual patient access to unapproved drugs.

Following a roundtable hosted by the two organizations in January, NCCS and ASCO prepared the Citizens’ Petition, which outlines criteria that balance patient access to unapproved therapies with protection of the clinical research system and patient safety.

The petition calls for FDA to establish standards in the following areas: program design, eligibility, data requirement, equitable access, informed consent, charging for drugs, physician reimbursement and transition issues upon FDA approval of the drug.

News and Notes
Second-Quarter Drug Prices
CMS released its list of second-quarter drug prices,available on ASCO’s website.

ASCO Issues Comments on Draft Medicare Local Coverage Policies
ASCO Comments to Empire Blue Cross on Off-Label Drug Uses: Empire Medicare Services, the Part B carrier for New Jersey and New York, recently issued a draft policy for off-label drug use that ASCO viewed as overly restrictive and burdensome to providers.  For drugs not listed in one of the approved compendia (which would require Medicare coverage), Empire proposed to develop a list of those that would be covered. In order to have an off-label use included in the list—and thus be eligible for coverage—providers were to submit data demonstrating safety and effectiveness in at least two phase III clinical trials or two phase II trials. ASCO sent a letter raising its concerns to Empire on March 21. 

Comments to Noridian on Genetic Testing: The Carrier Medical Director for Noridian Administrative Services in Utah has issued a proposed policy on coverage of genetic testing for the purpose of enhancing the clinical management of patients with inherited cancer-predisposing gene mutations.  ASCO has recommended refinements to the policy to remove obstacles to genetic testing for those with hereditary colorectal and endometrial cancer syndromes who might benefit from these tests.

CMS Issues 2007 Part D Formulary Guidelines
CMS has released final guidelines for Medicare Part D plan formularies for 2007.  ASCO has developed a brief summary of changes relevant for oncology.