Congress Should Ensure Providers are Kept Whole in Drug Pricing Negotiation

December 21, 2021

The Association for Clinical Oncology (ASCO), the American College of Rheumatology (ACR), and the American Academy of Neurology (AAN) sent a letter to U.S. Senate leadership supporting the Build Back Better Act’s (BBBA) goal of reducing the cost of prescription drug treatments while urging lawmakers to address unintended consequences of the bill’s drug pricing provision before passing the legislation.

ASCO, ACR, and AAN like many of the health care provisions in the U.S. House-passed version of BBBA that would support the medical community and help patients secure access to high-quality health care. However, the organizations express concern that the drug pricing provision will negatively impact patient access to critical prescription drugs under Medicare Part B and ask that Congress take steps to offset cuts to Part B reimbursement. ASCO, ACR, and AAN believe this can be accomplished by exempting Part B services from sequestration cuts implemented by the Budget Control Act of 2011 and subsequent extensions by Congress.

Data from the American Society of Clinical Oncology’s PracticeNET show that under BBBA, as it is currently written, oncology practices would experience an overall 3% cut to Medicare reimbursement, which would be detrimental to patients and practices, especially in rural and underserved areas. For negotiated drugs, oncology providers can expect a 41.5% decrease in total payments—even accounting for reduced acquisition costs—and by 2027, 38% of all hematology/oncology drugs administered today are expected to be selected for negotiation. As a result, the exact impact on a particular practice will depend on the specific services a practice provides.

As with past policies that decreased Medicare Part B reimbursement without full consideration of the way in which physicians must acquire, store, and provide treatments, BBBA could cause already struggling practices to have to make difficult decisions about the support services they are able to provide or their own viability. This threatens patient access to care and may result in many patients paying more for drugs and medical care—the opposite of what BBBA intends. This is a particularly high risk for Medicare beneficiaries in rural areas.  

ASCO will continue to support efforts to make health care more affordable for patients, while urging Congress to exempt Medicare Part B prescription drugs treatments from sequestration cuts. The Association will also continue to work with lawmakers as they consider and debate important health care policies in BBBA and future legislation.

Read the full letter.

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