Protecting Patient Access: Why Innovation In How Care Is Delivered Matters
For many patients, access to treatment is about more than whether a therapy is covered. It is also about what it takes to realistically fit that care into their lives.
On July 30, the Partnership to Fight Chronic Disease (PFCD) hosted a Congressional Hill Briefing examining the Centers for Medicare & Medicaid Services’ (CMS) proposed treatment of fixed-dose combination (FDC) therapies under the qualifying single-source drug (QSSD) definition in Medicare’s Drug Price Negotiation Program.
The discussion focused on the patient impacts related to how a proposed change could treat two separately FDA-approved products as a single qualifying single-source drug, even when one product contains an additional active ingredient that enables a different route of administration, such as moving from an intravenous infusion to a subcutaneous injection.
These kinds of distinctions can have a meaningful impact on patients. More convenient treatment options can reduce the time patients spend traveling to and receiving care, as well as the burden on family members and caregivers. For older adults and people living in rural or underserved communities, reducing these barriers can make a significant difference in their ability to stay on course with prescribed treatment.
During the briefing, patient and community advocates shared what these barriers can look like in real life.
As PFCD's Vice President of Policy and Advocacy Candace DeMatteis emphasized the importance of policymakers more fully considering the patient experience when evaluating changes to Medicare’s drug negotiation framework. Innovation is not only about developing new medicines; it can also mean finding better ways for patients to receive the treatments they need.
Anna Howard of the American Cancer Society Cancer Action Network highlighted the significance of understanding patients as people with lives, responsibilities, and challenges beyond their treatment. For patients living in rural communities, accessing care can mean traveling several hours to reach a cancer treatment facility. When a therapy offers a less burdensome way to receive treatment, that difference matters.
Burton Eller of the National Grange shared the story of a rancher in his 60s battling stage three cancer who was driving to Fort Worth three days a week for infusions, a schedule that consumed much of the week for both him and his wife.
Stories like these underscore why Medicare policy should account for the real-world impact of how care is delivered. Policies that unintentionally discourage investment in new formulations or routes of administration could limit future treatment options and make it harder for patients to benefit from innovations designed to make care more accessible.
PFCD, joined by 50 patient, provider, and health organizations, recently submitted comments to CMS urging the agency to reconsider its proposed approach to FDC therapies. As CMS considers changes to the Medicare Drug Price Negotiation Program, policymakers should ensure that the framework continues to support patient-centered innovation and recognizes the importance of expanding how and where patients can receive care.
Read the full comments to CMS from PFCD and 50 other organizations HERE.