The US Oncology Network – one of the nation’s largest and most innovative networks of community-based oncology physicians – remains deeply concerned with the drug negotiation provisions in the Build Back Better Act (BBBA). The provisions direct the Secretary of Health and Human Services to negotiate a Maximum Fair Price for certain drugs in Medicare Parts B and D (particularly, for those drugs that have been on the market for a certain length of time and have no generic or biosimilar competition). The provisions also alter the manner in which providers are reimbursed for administering those medications that could lead to unintended consequences to patient care.
While we appreciate efforts to reduce patient out-of-pocket costs that often lead to financial toxicity, the drug negotiation provisions in the Build Back Better Act are unprecedented and wide ranging. We encourage Congress to strongly consider the downstream impact of these policies on community-based practices and the patients they serve; and we further recommend that Congress explore options that avoid adverse impacts to provider reimbursement resulting from any potential negotiation on drugs.
The community-based setting offers cancer patients access to high-quality, cost-effective care in a location convenient to their home, family, caregivers, and support systems. Over the past decade, rising financial pressures have contributed to the closure of many community oncology practices, leaving patients with few options but to receive care in a less convenient, more costly setting.
Further, The Network notes that oncology providers are already facing a tidal wave of reimbursement cuts up to 10% on January 1, 2022, notwithstanding the uncertainty created by BBBA. The Network strongly recommends that Congress take action to support community oncology by addressing these looming Medicare cuts rather than adding to the uncertainty. The Network urges Congress to stop these cuts and support access to lifesaving treatment both now and in the future.
For more information on the Build Back Better Act, Click Here.