Jan 04, 2019
By Hilary Adams, ASCO Communications
More than 100 ASCO volunteers from across the country came to Capitol Hill on September 25-26 for the 2018 ASCO Advocacy Summit, where they urged Congress during 140 Congressional meetings to support cancer research and ensure access to high-quality care for the millions of people in the United States with cancer.
ASCO Policy Priorities
Attendees met with Members of Congress and their staffs to discuss four key issues affecting oncology care providers and their patients: financial barriers to clinical trials, step therapy, prior authorization, and federal funding. Specifically, ASCO volunteers urged lawmakers to take the following actions:
- Support the CLINICAL TREATMENT Act, a bill recently introduced in the U.S. House of Representatives that would require Medicaid plans to cover routine, non-experimental care costs associated with clinical trials participation for individuals with life-threatening conditions, including cancer. Medicaid insures nearly one-fifth of the U.S. population and is the only major payer that is not required by federal law to provide this coverage. Removing the states that already guarantee this coverage, there are still approximately 42.2 million Medicaid patients potentially without needed protection.
- Ask for greater transparency in prior authorization, a utilization management technique that requires a patient or provider to secure a pre-approval as a condition of insurance coverage for a prescribed medication, treatment, or medical item. Specifically, for House Members to sign on to the “Dear Colleague” letter to the Centers for Medicare and Medicaid Services (CMS) asking the agency to reduce the burden of prior authorization associated with Medicare Advantage plans. Prior authorization processes often require providers to submit detailed clinical rationale for use of a drug before treatment can proceed as planned. In ASCO’s 2016 Practice Trends Survey 78% of respondents cited prior authorization as a significant pressure associated with payers.
- Support the Restoring the Patient’s Voice Act, a bill that would enact sensible guardrails to protect patients from payer step therapy, or fail-first practices, which require patients to try and fail medications chosen by a payer before the payer will cover the medication originally prescribed by their health care provider. Step therapy policies are generally inappropriate for use in oncology due to the individualized nature of modern cancer treatment and the general lack of interchangeable clinical options. Although payers attempt to reduce health care costs through step therapy protocols, fail-first policies negatively impact patient health and increase the overall cost of the patient’s care.
- Pass a Fiscal Year (FY) 2019 spending bill that includes a $2 billion increase for the National Institutes of Health (NIH) and a commensurate increase for the National Cancer Institute (NCI). ASCO volunteers thanked Members of Congress for making the NIH and NCI a priority by increasing federal funding of research over three consecutive years, but noted that the U.S. research enterprise has not been fully restored in the wake of stagnant funding over the last decade.
At a reception on Capitol Hill, ASCO presented its Congressional Leadership Award to Rep. Kevin Yoder (KS-3), to recognize his commitment to advancing policies to support research and improve the practice environment for people with cancer. “Cancer knows no political parties or regional boundaries—it affects us all,” said Rep. Yoder in a news release. “For that reason, one of my top priorities since I have been in Congress is to ensure our researchers have every tool they need to find a cure for this deadly disease. I have made it a goal to double the National Institutes of Health’s funding over the next decade to save lives and dramatically reduce medical costs. Thank you to advocates from groups like the American Society of Clinical Oncology who walk through my door to discuss our shared goals of increased NIH funding and eradicating this horrible disease.”
Seven other members of Congress also attended the reception, and many spoke about their own experiences with cancer. The lawmakers in attendance were Rep. Chuck Fleischmann (TN-3), Rep. Gene Green (TX-29), Rep. Eddie Bernice Johnson (TX-13), Rep. Leonard Lance (NJ-7), Rep. Billy Long (MO-7), Rep. Paul Tonko (NY-20), and Rep. Fred Upton (MI-6).
The reception was followed by a networking dinner at the National Museum of the American Indian. Mara Liasson, national political correspondent for National Public Radio, gave a keynote address.
During a breakfast meeting on the second day of the summit, Sen. Bill Cassidy (LA), who has also been a physician for nearly three decades, counseled ASCO advocates about the day’s Congressional meetings. “When you go into these meetings, be a physician… bring the real-life story of real-life patients and how these policies impact them. That is how public policy should be formed,” he said.
ASCO also presented its Advocate of the Year Award to Ray D. Page, DO, PhD, FACOI, for his significant advocacy work on behalf of individuals living with cancer and their cancer care teams. “Ray never misses an opportunity to advocate on behalf of cancer care and our patients,” said Robin Zon, MD, FACP, immediate past chair of ASCO’s Government Relations Committee. “Ray uniquely understands the important role oncology professionals play in shaping health care policies that have a direct impact on our ability to provide high-quality cancer care for our patients.”
ASCO also recognized other advocacy champions who have been who have been exceptionally active in the Society’s advocacy activities throughout the year.
Technology helped Advocacy Summit participants make the most of their time on Capitol Hill. ASCO unveiled a new advocacy app which served as a one-stop shop for everything a summit attendee needed, including personalized schedules, background and legislative messaging, maps, and access to the ACT Network.
Results of ASCO’s Advocacy
During ASCO’s Advocacy Summit, Congress passed the Labor, Health and Human Services, and Education (“Labor-H”) appropriations bill, securing the requested $2 billion increase for NIH and a $179.1 million increase for NCI. 2018-2019 ASCO president Monica M. Bertagnolli, MD, FACS, FASCO, made a statement praising the House and Senate Appropriations Subcommittees for their efforts in supporting “biomedical research that made passage of this appropriations bill a reality.”
“Federal research funding has also brought about a revolution in our understanding of cancer, generating more precise and effective treatments increasingly targeted to each person’s tumor type, genetics, immune response, and treatment tolerance,” said Dr. Bertagnolli. “But our work is far from over, and as long as cancer continues to be the life-threatening burden it is today, our nation must continue to prioritize investment in cancer research.”
In addition to the passage of the Labor-H funding bill, several Members of Congress, whom ASCO volunteers met with during the summit, have signed on to both the CLINICAL TREATMENT Act and the Restoring the Patient’s Voice Act. Finally, the “Dear Colleague” letter was sent to CMS in mid-October with signatures from 103 House Members urging CMS to reconsider prior authorization protocols in Medicare Advantage plans.
Advocacy from Afar
ASCO members who could not attend in person participated in a Virtual Hill Day by sending almost 170 letters to their Congressional representatives urging them to take action on the policy priorities laid out at the beginning of the summit. ASCO members can still use the ACT Network to send messages to their elected officials to encourage them to act on priority issues. Access ASCO’s Advocacy Center tools, including the ACT Network.
Aside from participating in Virtual Hill Day efforts, cancer policy advocates who couldn’t make it to D.C. kept an eye on the action on social media by following the hashtag #ASCOAdvocacySummit. Before, during, and after the summit, ASCO’s official Twitter, Facebook, LinkedIn, and YouTube channels shared updates, pictures, and videos from Capitol Hill. Summit attendees themselves participated as well by live tweeting, liking, and sharing their experiences on Twitter.
Videos posted to ASCO’s Twitter and YouTube channels during the summit were recorded onsite during the event, and feature ASCO volunteers passionately discussing the importance of advocacy and offering perspectives on policy issues impacting oncology practices across the country. Videos recorded during the Advocacy Summit are available on ASCO’s YouTube channel in the ASCO in Action playlist.
Learn More and Get Involved
Have questions or want more information on the Advocacy Summit, grassroots opportunities, or ASCO’s position on federal legislation? Email our grassroots advocacy team at email@example.com. Stay connected to all the policies affecting cancer research and care at ASCO in Action.