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(September 19, 2000)

September 19, 2000

The Honorable ……
Washington, D.C. 20510

Dear Senator ……:

The ongoing debate over prescription drugs has highlighted for the cancer community a major shortfall in coverage for life-extending therapies for beneficiaries diagnosed with cancer. While most anti-cancer drugs are currently covered by the program because they are "incident to" physician services, some important drugs remain unreimbursed—notably hormonal agents for breast and prostate cancer—because they are available only in oral dosage.

In addition, the drug discovery pipeline is about to release significant new oral anti-cancer compounds that are not covered under current Medicare law. Offering great potential for enhanced survival, these new agents are based on a variety of cellular mechanisms that inhibit proliferation of cancer cells. Yet without amendment to the Medicare statute, beneficiaries will not have access to these life-extending anti-proliferative cancer drugs.

Cancer is a disease of the elderly, and Medicare beneficiaries are disproportionately affected. Beneficiaries with cancer rely on Medicare to fund their often costly drug therapy, and special coverage rules have been adopted by Congress to meet the unique needs of cancer patients. Most importantly, because cancer therapy frequently employs drugs "off-label"—i.e., for disease indications not specifically approved by the Food and Drug Administration—the statute requires coverage of medically appropriate off-label drug usage in treating cancer patients.

These protections are absolutely essential for patients with cancer, and the cancer community strongly supports coverage for all anti-cancer agents, including oral drugs, in Medicare Part B. Only by expanding Part B coverage to include oral anti-cancer drugs can the program continue to provide comprehensive quality cancer care under the supervision of a trained oncologist or other cancer specialist.

As the Presidential candidates debate prescription drug coverage for the elderly and this Congress considers end-of-session legislation, we believe now is the best time to add oral anti-cancer drug coverage to Part B. Coverage now will represent an impressive down payment on an overall Medicare drug benefit and will address concerns of cancer patients about their continuity and quality of care.

As representatives of people with cancer, cancer caregivers and cancer research organizations, we strongly urge your support for this urgently needed initiative.

Cancer Leadership Council

Alliance for Lung Cancer Advocacy, Support, and Education
American Society of Clinical Oncology
Cancer Care, Inc.
Cancer Research Foundation of America
The Children's Cause, Inc.
Coalition of National Cancer Cooperative Groups
Colorectal Cancer Network
Cure For Lymphoma Foundation
International Myeloma Foundation
Kidney Cancer Association
The Leukemia & Lymphoma Society
Multiple Myeloma Research Foundation
National Alliance of Breast Cancer Organizations
National Coalition for Cancer Survivorship
National Patient Advocate Foundation
National Prostate Cancer Coalition
North American Brain Tumor Coalition
Oncology Nursing Society
Ovarian Cancer National Alliance
Pancreatic Cancer Action Network
The Susan G. Komen Breast Cancer Foundation
US-TOO International, Inc.
Y-ME National Breast Cancer Organization

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