Yes, Medicare can Embrace Innovation

A recent announcement by Medicare may brighten the day of some cancer patients. Medicare just released a National Coverage Decision on the breakthrough immunotherapy cancer treatment known as CAR T. CAR T-cell therapy treatment involves removing and genetically engineering a patient’s immune system T-cells, multiplying the modified cells, and then returning them to the body to fight cancerous cells. The therapy treats rare cases of lymphoma and leukemia that do not respond to standard treatment. For these patients and their loved ones CAR T spells H-O-P-E.

On August 7, CMS indicated that Medicare will cover CAR T-cell therapy administered in places other than hospitals. This expands patient access to the breakthrough treatments by increasing the medical settings that will administer CAR-T to now include community-based cancer centers. Patients and caregivers no longer have to endure day-long travel to inconvenient hospital sites to receive this treatment. It also provides patients’ access to the treatment with the lower out-of-pocket copays and cost-sharing associated with community-based care.

The American Society for Clinical Oncology says this move “provides increased access to an innovative cancer treatment to Medicare beneficiaries nationwide” and that “the decision also opens the door for patients…” It is also proof that Medicare and innovation are not incompatible. Providing patients the right treatment, at the right time, in the right setting will always yield the best outcome. For this reason, Medicare should abandon its IPI proposal that would restrict real-time decision making of physicians and interfere with a patient’s personalized treatment plan. Amplify your voice by teaming up with Patients + Providers United to stop IPI and preserve access to quality care for the millions of Americans who are battling complex and chronic diseases.