House to Vote on Comprehensive Drug Pricing Legislation, Provisions Include Capping Medicare Patients’ Out-of-Pocket Prescription Drug Costs

December 12, 2019

Washington, D.C.—The U.S. House of Representatives will vote today on a bill intended to bring down patient prescription drug costs. Several of the bill’s numerous provisions are important to cancer care, including establishing an annual cap on Medicare enrollees’ out-of-pocket expenses, allowing some Medicare beneficiaries to spread out high-cost prescription cost-sharing over the course of the year, and expanding Medicare eligibility for low-income subsidies under the program.

A portion of the bill’s estimated savings would be directed to increasing federal investment in medical research at the National Institutes of Health (NIH) and extending funding for the Cancer Moonshot Initiative at the National Cancer Institute (NCI).

The following is a statement from Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN):

“Today’s vote in the House is an important step towards Congress addressing prescription drug costs for patients, especially for those enrolled in Medicare. Cancer is a disease more common with age and can be very expensive to treat. For Medicare enrollees who currently face unlimited cost-sharing for some of their prescription drugs, the financial burden can be overwhelming. Establishing an annual cap for outpatient prescription drug costs would enable patients to plan for their expenses and provide some financial relief for a population often on fixed incomes. Additionally, more than one in three Medicare enrollees taking a cancer drug in 2017 hit the catastrophic cap in just the first two months of the year, according to research done for ACS CAN by Avalere Health. Rather than requiring full payment upfront, we support allowing those patients with high-cost drugs to space out their prescription drug co-pays in installments. This change could further alleviate some cancer patients’ economic stress.

“Of course, the ability to afford prescription drugs at all—no matter the payment plan—is critical, which is why we are pleased the bill includes improvements to allow more low-income beneficiaries to qualify for financial assistance with their Medicare benefits.

“Directing projected savings from this bill to medical research, specifically extending the Cancer Moonshot Initiative at NCI, is a welcome inclusion. Sustainable federal funding increases for NIH and NCI are essential for the continued development of new tools to prevent, detect and treat this disease and we greatly appreciate lawmakers’ continued commitment to medical research investment.

“We also appreciate their recognition of prevention as an essential component to quality health care and strongly support the inclusion of a provision to eliminate cost sharing for seniors on Medicare who are hit with a surprise bill during a routine screening colonoscopy when a polyp is discovered and removed during the same procedure. ACS CAN has long advocated for the passage of this proposal to close a loophole that was already fixed in private insurance and is deterring a population at higher risk for disease from getting a potentially lifesaving screening.

“Cancer patients and survivors depend on access to quality, affordable medical care including prescription drug therapies and preventive screenings. On behalf of the more than 1.7 million Americans estimated to be diagnosed with cancer this year ACS CAN is encouraged by the House action to address these pressing issues and urges lawmakers to work in a bipartisan way to make provisions that will impact the cancer burden a reality.”

Media Contacts

Allison Miller
Director, Media Advocacy
Washington, D.C.
Alissa Crispino
Vice President, Media Advocacy & Communications
Washington, D.C.