COA Physician Survey: Medicare Part B Proposals Will Harm Patients, Increase Costs and Bureaucracy
Scarred by firsthand experience dealing with the negative patient impact of bureaucratic Pharmacy Benefit Manager (PBM) middlemen in the Part D program, the surveyed physicians fear recently proposed changes to the Medicare Part B program will reduce care choices, drive up costs, increase administrative burdens, and decrease physician autonomy.
"Cancer patients have endured decades of health 'reform' and big ideas from
COA commissioned the survey to gather physician perspectives on two specific proposals put forth by the
The web-based survey of 100 oncologists/hematologists and 50 rheumatologists found that providers were overwhelmingly concerned that the types of reforms being proposed would interfere with their ability to treat patients and provide timely, affordable access to care. Specifically, the survey found:
Physician Perspectives on a Competitive Acquisition Program (CAP) or Drug Value Program (DVP):
- 88% of providers believe a CAP or DVP program would take care decisions away from the person in the best position to make that decision;
- More than 87% believe it would limit their ability to provide the best care to patients;
- 75% of providers believe it would increase the administrative burden for their practices; and
- 61% of providers believe it would diminish their prescribing autonomy and ability to tailor prescriptions to the patient.
Physician Perspectives on Shifting Drugs from Medicare Part B to Part D:
- 85% of providers believe moving Part B drugs to Part D will create affordability issues for patients;
- 89% of providers believe it could delay treatment access;
- 92% believe it would reduce treatment choices; and
- 93% of providers believe it will increase the administrative burden.
COA supports the Administration's goal to lower the cost of prescription drugs. The status quo is no longer acceptable, and we must work together to get a handle on the price and cost of drugs and overall health care spending. Community oncologists, oncology nurses, administrators, and other practice professionals are the front-line providers of care to the majority of Americans with cancer. They understand the enormous problems created by escalating health care costs. Ensuring patients can afford and access life-saving cancer therapies is a top priority for community oncology.
However, history has shown that even well-intended policymaking can backfire, resulting in increased costs, less access to care, and harm to patients. This has been particularly true in cancer care, where Americans today are facing higher costs that can be tied directly to the unintended consequences of federal policymaking. COA is particularly concerned about sweeping proposals for changes to the Medicare program and the impact that rushing to implement those would have on patients.
"Faulty government policy on Medicare Part B has resulted in massive consolidation of our nation's cancer care delivery system as documented by cancer clinic closings and care moving into the much more expensive hospital setting. The result has been access problems and higher costs for Americans with cancer, especially seniors. And it's no surprise that health care spending has steadily increased with this consolidation," said
While much of the debate over PBMs focuses on economics, there is often not enough discussion about the impact PBMs have on patients. The sad fact is that these middlemen often make more money by delaying or denying patients access to necessary medications. COA has documented real-life patient horror stories from practices and physicians about patients battling cancer who have suffered at the hands of PBMs due to delayed coverage decisions, denial of coverage, arguments with physicians over proper treatment, and failure to receive medications in a timely manner. These concerns are clearly reflected in the results of the survey.
COA and community oncology practices are actively working on solutions to high drug prices and the cost of cancer care by relying on the real-world medical experiences of providers on the front lines of cancer care to craft viable, truly patient-centric solutions. This includes providing practices with the support that they need to succeed in the
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