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Strong Support for Medicare Coverage of Oral Cancer Drugs

Strong Support for Medicare Coverage of Oral Cancer Drugs

WASHINGTON—Nearly 9 out of 10 American adults favor changing Medicare rules to cover all approved cancer drugs for its beneficiaries, including oral medications, according to a poll commissioned by the National Coalition for Cancer Survivorship (NCCS). Further, 83% said they would support increasing Medicare’s cancer budget by 1% to pay the additional costs, and 83% said that Congress should pass legislation this year requiring coverage of oral cancer agents.

The NCCS released the poll results at a Capitol Hill press conference intended to alert the public to two identical bills pending in the Senate and House that would require Medicare to cover all cancer drugs approved by the Food and Drug Administration. According to the coalition, 8.3 million (20%) of the 41.5 million Medicare beneficiaries have at least one diagnosis of cancer.

"At a time of unprecedented scientific breakthroughs in the treatment of cancer, we can’t stay on the sidelines as Medicare patients are denied access to life-extending drugs simply because of a loophole in Medicare policy," said NCCS president and CEO Ellen Stovall.

Both pieces of pending legislation are called the Access to Cancer Therapies Act. Senators Olympia Snowe (R-Maine) and John D. "Jay" Rockefeller IV (D-WVa) introduced the Senate bill. Rep. Deborah Pryce (R-Ohio) introduced the companion measure in the House. Both bills are currently in the congressional hearing stage.

At the time of the press conference, the Snowe-Rockefeller bill had 32 other senators co-sponsoring it, and Rep. Pryce’s measure was backed by 226 co-sponsors, more than half the House membership.

Under current law, Medicare only covers oral cancer medications if they are also available in an intravenous form. "Obviously, the Medicare program has to play some serious catch-up," Sen. Snowe said. "To do otherwise essentially creates a de facto two-tiered health care system—one tier for those with the money to pay for the more expensive treatments and another tier for the Americans who cannot afford to pay for the treatments that are being developed."

The polling firm of Harris Interaction conducted the telephone poll of 1,007 regionally representative Americans, age 18 or older, between March 7 and March 10. The poll had a margin of error of plus or minus 3.1%.

A New Era

Larry Norton, MD, director of medical breast oncology, Memorial Sloan-Kettering Cancer Center, and president of the American Society of Clinical Oncology, noted at the press conference that basic research advances had opened an era in which many new cancer drugs will be oral medications.

"It is critical today, and it is going to be even more critical tomorrow, to make sure that older Americans have access to these oral medications," he said. "It makes no sense to develop these exciting treatments and not be able to apply them to all Americans."

According to figures released by Rep. Pryce, Medicare currently covers 90% to 95% of the cancer drugs used by its beneficiaries. However, within the next decade, oral cancer drugs will rise from 5% of the market to 25%, a fact also noted by Sen. Rockefeller. "This is a matter of life or death," he said. " We want to make sure that all cancer therapies can be reimbursed under Medicare." 

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