Access to Affordable Cancer Drugs

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Fighting cancer is a struggle. Getting access to the lifesaving cancer drugs you need – at a price you can afford - shouldn't be.

Too many cancer patients face barriers in getting health insurance coverage for the prescription drugs recommended by their oncologist. And then, oftentimes, even when coverage is there, their share of the cost can bust the household budget.

We must find new solutions to make cancer drugs more accessible and affordable for cancer patients - whether through new regulations or laws passed by Congress and your state legislature.
 

56% of cancer patients and survivors are worried about being able to afford their treatment

Latest Updates

December 17, 2019

Congress is poised to pass a funding bill this week that includes a $2.6 billion increase for medical research at the National Institutes of Health (NIH). The measure, agreed upon by both House and Senate conference committee members, also provides $296 million increase for the National Cancer Institute (NCI).

December 12, 2019
National

The U.S. House will vote today on a bill intended to bring down patient prescription drug costs. Several of the bill’s 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.

September 19, 2019
National

House Speaker, Nancy Pelosi (D-Calif.), introduced legislation intended to bring down patient drug costs.

July 25, 2019
National

Today the Senate Finance Committee is marking up the Prescription Drug Pricing Reduction Act (PDPRA) of 2019, which includes a provision to cap Medicare beneficiaries’ out-of-pocket prescription drug costs in Medicare Part D, among several other proposed changes intended to bring down patient costs.

Access to Affordable Cancer Drugs Resources

ACS CAN is very concerned about proposed policy changes that would move coverage of cancer and supportive care drugs from Part B to Part D. Proposed policy changes could jeopardize patient access to drugs, create potential safety issues, and increase out-of-pocket costs for patients who already struggle to afford cancer treatment under the current Medicare program.

In 2003, Congress passed the Medicare Modernization Act (MMA), which created an outpatient prescription drug benefit in the Medicare program. Known as Part D, the prescription benefit is operated exclusively through private insurance plans that contract with Medicare. To ensure that beneficiaries have coverage for the drugs they need Part D plans are required to cover at least two drugs in each therapeutic class. A therapeutic class is a group of medications that are used to treat the same condition. 

Pharmacy benefit managers (PBMs) are entities that administer prescription drug programs for many private, public, and employer health insurance plans. PBMs establish pharmacy networks, negotiate prices with pharmaceutical manufacturers on behalf of their clients, and provide basic claims administration.