President Trump's Proposed Medicare Reforms Spark Concern Among Oncologists

Community Oncology Alliance survey indicates concern that Medicare Part B reforms will have a negative effect on patient care and drive up costs.

Physicians are concerned about the Trump administration’s recent proposals to reform the Medicare Part B program, according to a survey released by the Community Oncology Alliance (COA).

Surveyed physicians took issue with President Trump’s blueprint to lower drug prices and reduce out-of-pocket costs, which he released last week. The blueprint contained 2 specific proposals put forth by the Medicare Payment Advisory Commission (MedPAC), including reforms to allow select private vendors to negotiate drug prices with manufacturers and a proposal to shift prescription drugs from the Medicare Part B program into the Medicare Part D program.

According to the survey, physicians fear the changes will reduce care choices, drive up costs, increase administrative burdens, and decrease physician autonomy.

The web-based survey, conducted by COA, queried 100 oncologists/hematologists and 50 rheumatologists to collect opinions on the new proposals. The survey results were comprised of physician perspectives on both the Competitive Acquisition Program (CAP), also referred to as the “Drug Value Program” (DVP), and on shifting drugs from Medicare Part B to Part D.

According to the findings, the majority (88%) of physicians believe a CAP or DVP program would take care decisions away from the person in the best position to make that decision. More than 87% responded that they believe it would limit their ability to provide the best patient care, 75% stated that it would increase the administrative burden for their practices, and 61% believe it would diminish their prescribing autonomy and ability to tailor prescriptions to the patient.

Eighty-five percent of physicians responded that they believe moving Part B drugs to Part D will create affordability issues for patients and 89% indicated that it could delay treatment access. The majority believe that it would reduce treatment choices (92%) and increase the administrative burden (93%).

In a press release about the survey, COA addressed its own concerns about the Medicare changes, stating that, “The Trump Administration should be seeking to reduce the role and influence of middlemen who come between patients and their providers, not increase it as proposed.”

The Pharmaceutical Research and Manufacturers of America (PhRMA) also issued a statement in response to the president’s drug pricing blueprint.

“These far-reaching proposals could fundamentally change how patients access medicines and realign incentives across the entire prescription drug supply chain,” PhRMA president and CEO Stephen J. Ubl said in the statement. “While some of these proposals could help make medicines more affordable for patients, others would disrupt coverage and limit patients’ access to innovative treatments.”

In the statement, Ubl noted that drug prices increased only 1.9% last year, while patients’ out-of-pocket costs continued to skyrocket. “Giving patients access to negotiated discounts at the pharmacy counter and protecting seniors in Medicare Part D from catastrophic costs would help make medicines more affordable,” he stated.

References

COA Physician Survey: Medicare Part B Proposals Will Harm Patients, Increase Costs and Bureaucracy [news release]. COA’s website. https://www.communityoncology.org/2018/05/16/may-16-coa-physician-survey-medicare-part-b-proposals-will-harm-patients-increase-costs-and-bureaucracy/. Accessed May 16, 2018.

PhRMA Statement on President Trump’s Drug Pricing Blueprint [news release]. PhRMA’s website. https://www.phrma.org/press-release/phrma-statement-on-president-trump-s-drug-pricing-blueprint. Accessed May 16, 2018.