• Facebook
  • Rss
  • Twitter
  • Youtube
  • Store
  • Donate
NCCS - National Coalition for Cancer Survivorship
  • About
    • Our Mission
    • Our History
    • Our Leadership
      • Policy Advisors
    • Employment
    • Partnerships
    • Financial Information
  • Policy
    • Quality Cancer Care
    • Access to Care
    • Health Equity
    • Redefining Functional Status (RFS)
    • 2020 State of Cancer Survivorship Survey
    • Cancer Care Planning and Communications Act (CCPCA)
  • Get Involved
    • What is Advocacy?
    • Cancer Policy and Advocacy Team (CPAT)
    • Elevating Survivorship
    • Survivor Stories
    • Cancerversary
    • State Based Cancer Advocacy
  • Resources
    • COVID-19 Resources for Cancer Survivors
    • Survivorship Checklist
    • Cancer Survival Toolbox
    • Telehealth
    • Survivorship Champions
    • Publications
      • Talking With Your Doctor
      • Self Advocacy
      • Employment Rights
      • Remaining Hopeful
    • Cancer Convos Podcast
    • Taking Charge of Your Care
    • Care Planning for Cancer Survivors
    • Tools For Care Providers
    • Order Our Resources
  • News
  • Events
    • Ellen L. Stovall Award
      • Nominations
      • Honorees
      • Sponsors
      • Committees
    • From Shadows to Life: A Biography of the Cancer Survivorship Movement
    • Cancer Policy Roundtable
      • Spring 2021 Cancer Policy Roundtable
      • Fall 2020 Cancer Policy Roundtable
      • Spring 2020 Cancer Policy Roundtable
    • Cancer Policy and Advocacy Team (CPAT) Symposium 2020
    • Webinars
  • Contact Us
  • Search
  • Menu Menu
  • 0Shopping Cart

Year-End MATCH (DEADLINE Dec 31): Donate & Make a Difference | Donate

NCCS Issue Statement HHS CMS

NCCS Expresses Reservations Regarding Effectiveness and Impact of New CMS Drug Pricing Proposal

October 22, 2018/in Cancer News, Cancer Policy Blog Access to Care, Drug Pricing, Financial Toxicity, Health Equity Issue Statements, NCCS News /by actualize
Shelley Fuld Nasso

By Shelley Fuld Nasso

NCCS Chief Executive Officer

October 22, 2018. – A focus of the National Coalition for Cancer Survivorship (NCCS) since it was founded over thirty years ago continues to be empowering patients to make informed decisions, and this includes transparency about the cost of health care.

The Centers for Medicare & Medicaid Services (CMS) recently proposed that list prices be included in direct-to-consumer (DTC) television advertisements of drugs that are reimbursed by Medicare and Medicaid. While we understand that CMS is taking small and concrete steps to advance its drug pricing agenda, we do not believe that the DTC proposal will achieve transparency, advance the effort to make Americans more informed health care consumers, or reduce drug prices. In fact, there is some concern that the proposal could harm patients and further complicate their decisions about care.

This proposal will affect only a portion of drugs—those that are advertised in television DTC ads—and will not even clearly affect prices for those drugs and is even less likely to affect those drugs not advertised in this manner.
First, the proposal to require list prices in certain DTC ads will provide cancer patients pricing information for only a portion of their care. Many drugs will not be subject to drug pricing transparency requirements because they are not advertised in DTC television ads. As a result, this proposal will not result in the provision of comprehensive information about cancer care costs to cancer patients. Cancer patients might have access to information about some of their drug costs and no information about others, as well as limited information about the cost of other elements of care. In addition, the proposal does not require that patients be provided the cost information that is most important to them, which is the information about what their treatment options will cost them in out-of-pocket spending. Neither does the proposal ensure communication about how their third-party insurance will cover their care. In short, this does not represent true transparency that is beneficial to patients and their decision-making process.

Second, cancer patients face difficult decisions from the time of diagnosis and in some circumstances they must make decisions under time pressure. Incorporating list prices of drugs into their decision-making would be a challenge even if they were provided comprehensive pricing information that can be compared. The CMS proposal falls far short of that standard and may instead create confusion and concern among cancer patients.

For example, NCCS believes that there is a risk that cancer patients may experience something akin to “sticker shock” if they see the prices of cancer drugs listed in DTC ads. The reaction to this sticker shock could be to forgo or delay care because of price concerns, even though the price in the DTC ad is not the cost that the patient may bear.

Although CMS suggests that it might consider a new budget-neutral payment code for doctors to speak with patients on the benefits of drugs and drug alternatives, we are not persuaded that this effort—even if it is pursued by CMS—would be sufficient to ensure informed decision-making by patients. NCCS and its colleagues in the cancer community strongly advocate the establishment of a cancer care planning service that would permit consideration of treatment options, the review of treatment side-effects and long-term treatment management, and the cost of care (including prices of treatments and relevant patient cost-sharing responsibilities). The care planning service we envision is comparable to the service that is provided to patients through the Oncology Care Model demonstration project and is a more comprehensive service than is mentioned in the current proposal.

Finally, the proposal to list prices in DTC ads is intended to reduce drug prices. We are not persuaded that the listing of prices in DTC ads will in fact reduce the price of drugs at time of market introduction or the possibility of price increases after market entry. This proposal will affect only a portion of drugs—those that are advertised in television DTC ads—and will not even clearly affect prices for those drugs and is even less likely to affect those drugs not advertised in this manner. Because the proposal may fail to achieve its fundamental goal and creates additional problems for patients, we cannot lend our support to it.

We are also concerned that the DTC ad proposal will deflect attention from efforts that might be more effective in protecting patient access to affordable medications and in empowering patients to choose treatments on the basis of effectiveness, impact on quality of life, and cost to them and the health care system. Comprehensive, out-of-pocket cost information that patients can use to compare treatments and costs would be a much more significant step forward to achieving actual transparency than the current CMS proposal.

https://canceradvocacy.org/blog/health-care-roundup-oct-19-2018/
https://canceradvocacy.org/policy-comments/nccs-joins-clc-concerns-hhs-step-therapy-plan/

Tags: cancer care, Cancer Survivorship, CMS, drug pricing, financial issues, HHS, issue statement, price transparency
Share this entry
  • Share on Facebook
  • Share on Twitter
https://canceradvocacy.org/wp-content/uploads/2018/10/NCCS-Issue-Statement-HHS-CMS.jpg 600 1200 actualize https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png actualize2018-10-22 10:23:062020-07-06 10:05:21NCCS Expresses Reservations Regarding Effectiveness and Impact of New CMS Drug Pricing Proposal
You might also like
NCCS Blog CPM Logo NCCS Applauds House Vote on Behalf of Patients to Defend the ACA and Its Pre-Existing Condition Protections
HHS Humphrey bldg 1200 NCCS, Cancer Groups Urge CMS to Withdraw Most Favored Nation (MFN) Medicare Part B Rule That Will Harm Patients and Reduce Access to Care
NCCS Starburst 250px What Caught Our Eye: House Passes ACA Repeal, Faces Senate Hurdles; Risky Prostate Cancer Treatment; Medical Debt; ‘Right to Try’; Rx Pricing
Brawley webinar COVID 19 blog img2 COVID-19 and Cancer: A Conversation with Cancer Control Expert Otis Brawley, MD
ProtectOurCare 1024px ACA Update | July 14, 2017: Updated BCRA Released; 30+ Cancer-Related Groups Join in Opposition
ProtectOurCare 1024px ACA Update | September 29, 2017 – Repeal Pulled for Now, Trump Admin’s Active Efforts to Undermine ACA Marketplace Ramp Up
NCCS Starburst Thumbnail WCOE: Matthew Herper Asks the Question “What Is This Worth to You?”
NCCS Starburst 250px What Caught Our Eye: Strengthening the ACA; the Harm of Medical Debt; Bone Symptoms After Treatment; and More

Latest News

NCCS Founders at 1990 Assembly

The Birth of the Cancer Survivorship Movement and How It Transformed Cancer Care for Millions

March 25, 2021
Guest Post by Judith L. Pearson Best-Selling Author of From Shadows to Life: A Biography…
Read more
https://canceradvocacy.org/wp-content/uploads/2018/02/10-Founders-1990-NCCS-Assembly.jpg 600 1200 NCCS Staff https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png NCCS Staff2021-03-25 10:36:202021-03-25 13:46:05The Birth of the Cancer Survivorship Movement and How It Transformed Cancer Care for Millions
HHS Humphrey bldg 1200

Biden Rescinds Trump Admin Proposal to Limit Medicare Part D Coverage of Drugs in “Six Protected Classes”

March 19, 2021
This week, the Biden administration rescinded a Trump administration-proposed plan…
Read more
https://canceradvocacy.org/wp-content/uploads/2017/10/HHS-Humphrey-bldg-1200.jpg 600 1200 NCCS Staff https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png NCCS Staff2021-03-19 13:36:192021-03-23 14:46:18Biden Rescinds Trump Admin Proposal to Limit Medicare Part D Coverage of Drugs in “Six Protected Classes”
CDC Headquarters

NCCS Recommends That States Allocate COVID-19 Vaccines to Cancer Care Providers

March 1, 2021
The National Coalition for Cancer Survivorship (NCCS) and the Cancer Leadership Council…
Read more
https://canceradvocacy.org/wp-content/uploads/CDC_Headquarters_PHIL_pubdomain_1200.jpg 600 1200 NCCS Staff https://canceradvocacy.org/wp-content/uploads/2020/06/NCCA-Logo.png NCCS Staff2021-03-01 15:49:432021-03-04 17:45:07NCCS Recommends That States Allocate COVID-19 Vaccines to Cancer Care Providers

Take Action

Stovall Award

The Ellen L. Stovall Award for Innovation in Patient-Centered Cancer Care is a unique opportunity for patients and survivors to recognize pioneers who are transforming the cancer care system.

Join CPAT

The NCCS Cancer Policy & Advocacy Team (CPAT) is a program for survivors and caregivers to learn about pressing policy issues that affect quality cancer care in order to be engaged as advocates in public policy around the needs of cancer survivors.

Share Your Story

NCCS represents the millions of Americans who share a common experience – the survivorship experience – living with, through and beyond a cancer diagnosis.

STAY CONNECTED

Together we can improve cancer care for survivors! Sign up to be the first to know about cancer policy issues and ways to take action

  • About
    • Our Mission
    • Our History
    • Our Leadership
      • Policy Advisors
    • Employment
    • Partnerships
    • Financial Information
  • Policy
    • Quality Cancer Care
    • Access to Care
    • Health Equity
    • Redefining Functional Status (RFS)
    • 2020 State of Cancer Survivorship Survey
    • Cancer Care Planning and Communications Act (CCPCA)
  • Get Involved
    • What is Advocacy?
    • Cancer Policy and Advocacy Team (CPAT)
    • Elevating Survivorship
    • Survivor Stories
    • Cancerversary
    • State Based Cancer Advocacy
  • Resources
    • COVID-19 Resources for Cancer Survivors
    • Survivorship Checklist
    • Cancer Survival Toolbox
    • Telehealth
    • Survivorship Champions
    • Publications
      • Talking With Your Doctor
      • Self Advocacy
      • Employment Rights
      • Remaining Hopeful
    • Cancer Convos Podcast
    • Taking Charge of Your Care
    • Care Planning for Cancer Survivors
    • Tools For Care Providers
    • Order Our Resources
  • News
  • Events
    • Ellen L. Stovall Award
      • Nominations
      • Honorees
      • Sponsors
      • Committees
    • From Shadows to Life: A Biography of the Cancer Survivorship Movement
    • Cancer Policy Roundtable
      • Spring 2021 Cancer Policy Roundtable
      • Fall 2020 Cancer Policy Roundtable
      • Spring 2020 Cancer Policy Roundtable
    • Cancer Policy and Advocacy Team (CPAT) Symposium 2020
    • Webinars
  • Contact Us

National Coalition for Cancer Survivorship
8455 Colesville Road  |  Suite 930  |  Silver Spring, MD 20910
877-NCCS-YES  |  info@canceradvocacy.org
Privacy Policy  |  Terms and Conditions

Copyright © 1995-2021 by the National Coalition for Cancer Survivorship
National Coalition for Cancer Survivorship, NCCS, Cancer Survival Toolbox, and related Logos are registered in the United States as trademarks of the National Coalition for Cancer Survivorship.

Health Care Roundup: Drug Pricing in TV Ads; Even with Insurance, Serious Illness... NCCS Starburst 250px NCCS Blog CPM Logo NCCS Concerned About New CMS Guidance on 1332 Waiver Process
Scroll to top

Harmar Brereton, MD

Founder
Northeast Regional Cancer Institute

 

“Perhaps one of the most impactful collaborations in Dr. Brereton’s extraordinary career remains his early work and long friendship with Ellen Stovall. Through him, and in turn through the thousands of lives he has touched, Ellen’s work continues, and her mission lives on.”

—Karen M. Saunders
President, Northeast Regional Cancer Institute