URGES PRESIDENT BUSH TO ENSURE FAIR
May 23, 2002
Dear Mr. President:
The undersigned groups
represent cancer patients, providers and researchers. As you know, the
Nation's investment in cancer research is beginning to reap significant
returns in reduced morbidity and mortality from cancer, a process that
your Administration has supported through generous budget recommendations.
While cancer research is thriving in many ways, there is great concern
in the cancer community with respect to the infrastructure for delivering
services for prevention, diagnosis and treatment of the disease.
Viewing these developments, cancer patients could conclude that cancer care is significantly at risk for the Medicare population, which represents the majority of cancer diagnoses. Each of these unrelated reimbursement issues is uniquely important to the overall system of care in this country, and there are no reasonable or appropriate tradeoffs among them.
Thus, we strongly resist suggestions that expansion of Medicare coverage for oral anti-cancer drugs should be funded by an overall reduction in payments to physicians for chemotherapy. One is not a replacement for the other; instead, each of these elements is essential if patients are to have appropriate access to the lifesaving treatments that flow from our Nation's research investment.
Cancer is a complicated disease requiring multi-disciplinary approaches and access in a variety of geographical and institutional settings. Correspondingly, reimbursement for cancer care cannot be subject to severe reductions without consequences extending throughout the system of care.
While all in the cancer patient and provider community agree that reform of chemotherapy reimbursement is necessary, it is critical that such reform be undertaken in a way that will not undermine patient care and adversely affect health outcomes. The cancer patient community is particularly concerned that such momentous changes are being undertaken without the serious study that they require. Congress requested but never received a study by the General Accounting Office (GAO) that would answer the critical question of the actual cost of providing cancer care in these settings. In the absence of meaningful data from GAO, oncology professional societies are pursuing their own studies, though we have received indications that these are likely to be dismissed as non-objective. Some Members of Congress and many patient advocates believe that the task of developing the needed data should be assigned to the Institute of Medicine for a thorough and objective review. We would like to urge your careful consideration of this alternative. The risks for patients are too great to proceed in the absence of strong evidence on the issues in question.
As you have been thoughtful in your recommendations for research funding, we also would appreciate your careful deliberation in any efforts to revise or reform the current payment system for cancer care.
cc: The Honorable
Tommy Thompson, Secretary of HHS
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