ASCO submitted comments to a Senate Finance Committee markup on the “The Prescription Drug Pricing Reduction Act (PDPRA),” a package of proposals aimed at addressing the high cost of prescription drugs.
In the letter, ASCO commends the committee for taking important steps to address the high cost of prescription drugs, but also express concerns that certain provisions may have unintended consequences for patients with cancer and the oncologists who treat them. During the hearing, the committee passed the package 19-9.
ASCO’s recommendations on specific sections of the proposal include, but are not limited to:
- Including Value of Coupons in the Determination of Average Sales Price for Drugs, Biologicals, and Biosimilars under Part B—ASCO has deep concerns about the potential for unintended consequences stemming from this provision. Specifically, the society is concerned that Medicare beneficiaries with cancer may have a greater financial burden if coupons become less accessible.
- Establishing a Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars—The current payment system for in-office administered drugs, including chemotherapy, was created to ensure that the costs to acquire, store, handle, and dispose of these treatments do not hinder access and availability. As the committee considers establishing a maximum add-on payment for such drugs, ASCO urges policymakers to ensure that the cap amount sufficiently covers necessary costs and is updated frequently to keep up with the changing practice environment.
- Publicly Disclosing Drug Discounts and Other PBM Provisions—ASCO applauds efforts to improve transparency in the pharmacy benefit managers (PBM) market. The society has long maintained that the misapplication of non-oncology performance metrics results in claw backs to pharmacies and has no basis in statute but is highly profitable for PBMs.
- Increasing Use of Real-Time Benefit Tools—ASCO supports the proposal for Medicare Part D insurers to provide a “real-time benefit tool (RTBT)” that allows insurers to electronically send formulary and benefit information to prescribing clinicians, using technology that integrates with clinicians’ electronic prescribing and electronic health record (EHR) systems. Such transactions, when integrated into qualified EHRs, could increase efficiencies. ASCO also supports awarding credit to physicians using RTBTs under the Merit-Based Incentive Payment System.
Read the full comment letter.
ASCO will continue to weigh in on legislative efforts to advance PDPRA and other bills intended to address the high cost of prescription drugs. Visit ASCO in Action for updates on this issue and the latest cancer policy news.