Oncologists Oppose Stark Bill

September 1, 2002

Depending on what the Senate does in September, there is a slight chance Congress could act on the Medicare Market Acquisition Drug Price Act (H.R. 5167). Introduced by Rep. Pete Stark (D-Calif) in July, the bill would change the way Medicare reimburses oncologists for the oncology drugs they purchase to administer to patients in the office. Even the American Society of Clinical Oncology (ASCO) agrees change in the reimbursement format is necessary. Nevertheless, Paul A. Bunn, Jr, MD, president of ASCO, says, "Under this bill, reductions in Medicare reimbursement would make it very difficult for many doctors to continue providing high-quality treatment to people with cancer."

Depending on what theSenate does in September, there is a slight chance Congress could act on the Medicare MarketAcquisition Drug Price Act (H.R. 5167). Introduced by Rep. Pete Stark (D-Calif)in July, the bill would change the way Medicare reimburses oncologists for theoncology drugs they purchase to administer to patients in the office. Even theAmerican Society of Clinical Oncology (ASCO) agrees change in the reimbursementformat is necessary. Nevertheless, Paul A. Bunn, Jr, MD, president of ASCO,says, "Under this bill, reductions in Medicare reimbursement would make itvery difficult for many doctors to continue providing high-quality treatment topeople with cancer."

The Stark bill would pay physicians only 105% of the averageprice charged by drug manufacturers. ASCO calls this a "defective"approach for several reasons. For example, although doctors almost always buytheir drugs from wholesalers, the Medicare payment of a 5% increase over themanufacturer’s average price could, by itself, fail to cover the wholesaler’smarkup to the physician.

Rep. Stark will have a hard time convincing Congress to pass his bill thisyear. The House passed a Medicare reform bill in June, but nothing on paymentfor chemotherapy drugs was included. In response, Stark then introduced hisfreestanding bill. For the Stark bill to have any realistic chance of actionthis year, it will have to be introduced by someone in the Senate and attachedto a Medicare reform bill. The Senate was unable to pass a Medicare reform billin July but may try again in September.