Editor’s note: Dr. Hudis hosts the ASCO in Action Podcast, which focuses on policy and practice issues affecting providers and patients. An excerpt of a recent episode is shared below; it has been edited for length and clarity. Listen to the full podcast online or through iTunes or Google Play.
In September, ASCO held its 2019 Advocacy Summit. More than 130 oncology care providers from across the United States came here to Washington, DC, to meet with Members of Congress and to urge support for policies that improve access to high-quality, high-value care for people living with cancer. This is one of the highest-impact events that ASCO holds every year. There's nothing like seeing ASCO advocates hit the halls of Congress with such passion and dedication, with the collective goal of ensuring that lawmakers focus on policy changes that will improve the lives of people with cancer and the care they receive.
CH: ASCO president Dr. Howard A. "Skip" Burris kicked off the activities at the Advocacy Summit and spoke about why it's so important for us to be on Capitol Hill.
HB: ASCO's on Capitol Hill so that our members actually get to meet with their representatives, so they understand how important cancer care is to this country, and to make sure that they understand the issues that are facing our patients who are experiencing cancer. The decisions that Congress makes regarding health care and cancer care are so important and powerful to patients with cancer. Access to therapy, timely access to getting treatments initiated, making sure that there's appropriate coverage of new therapies, all those things are critical for us to implement the great scientific and clinical advances that we've made into the care and outcomes for our patients.
CH: ASCO advocates asked lawmakers for their support for legislation that will make a big difference in the lives of individuals with cancer. One of those pieces of legislation is HR 913, the CLINICAL TREATMENT Act, which would guarantee coverage of the routine care costs associated with clinical trial participation for Medicaid enrollees with life-threatening conditions, including cancer. Medicaid is the only major payer, including Medicare, that is not required to cover these care costs today, and we hope to address this.
Dr. Karen Winkfield, chair of ASCO's Diversity Inclusion Task Force, says that changing this policy is critical to improving the validity of clinical research data and to improving patient outcomes. Dr. Karen Winkfield joined other ASCO advocates in urging members of Congress to support this bill.
KW: The CLINICAL TREATMENT Act is vitally important because it will allow all patients equal opportunity to access clinical trials. This is not only beneficial to the patients, but also other individuals who may come from the same backgrounds, including racial and ethnically diverse populations, and those of lower socioeconomic status. We want our clinical trial to be representative of every single individual in this country.
CH: The Advocacy Summit was packed with meetings with congressional lawmakers and their staff. Dr. Jason Westin, a member of ASCO's Government Relations Committee, participated in the summit and he spoke about why these direct meetings are so important.
JW: I think it is important for cancer doctors and professionals to be advocates for our patients. There are so many opportunities for us to help our patients in the clinic and in the research arena, but if we're not involved in advocacy then others are advocating in directions that may not benefit our patients. Many doctors view advocacy as somebody else's job, or they view it as something that's not important for them to be involved in, but I think if we don't step up, if we're not sitting at the table, then we may be on the menu.
CH: Many ASCO members are concerned with payer-imposed strategies that are designed to contain costs, but often unnecessarily, and sometimes dangerously, delay care for patients with cancer. Dr. Melissa Dillmon, chair of ASCO's Government Relations Committee, explained why these utilization management practices can be particularly harmful in cancer care, and spoke about legislation that will help address these concerns.
MD: Utilization management strategies, like step therapy and prior authorization, hurt our patients because they cause delays in care and cause patients to take drugs that are less effective. So, we are asking for support on two critical bills.
One is Improving Seniors' Timely Access to Care Act, which looks at prior authorization and simplifying the process by making sure that there's timely approval of medications that are critical to getting them on treatment and getting them healthy again.
The other act that we're asking for support on is the Safe Step Act, which really looks at step therapy and making sure that if step therapy is in place in an insurance program, that it does not prevent patients, especially oncology patients, from getting the best drug at the right time.
As oncologists we're fortunate in that drugs are being developed in a rapid manner, and we have many new drugs to help us fight different cancers. But we don't always have the ability to use the cheapest drug because the best drug is sometimes the newest one. And it may not be the one that's first approved on that step therapy utilization management strategy.
CH: One of the highlights of the Advocacy Summit is presenting ASCO's Congressional Champion of the Year Award to lawmakers whose leadership on behalf of patients with cancer deserves special recognition. This year, we recognized Congressman Ben Ray Luján from New Mexico and Congressman Gus Bilirakis from Florida for their work. Congressman Luján addressed the attendees at the reception.
BL: Your work and the difference you make every day saves people's lives. And it's certainly why I'm hopeful that more of my colleagues that have not had the chance to learn from you take a moment to meet with you, to spend time with you, to understand the magnitude of a difference that you're delivering for the constituencies that we all represent.
CH: We also recognized ASCO volunteers whose advocacy efforts made a significant impact in 2018. Dr. Alexandra Thomas, a participant in ASCO's Leadership Development Program, was named ASCO's Advocate of the Year.
AT: Receiving this honor only makes me embrace the exciting work ahead even more. And I hope that will include extending our network so even more voices can join in this chorus, so Dr. Burris's picture of the ASCO Advocacy Summit will get bigger each year. But perhaps even more importantly, the virtual picture will get bigger as more of us join in and advocate to tell our patients' stories and realize robust and continuous government support will improve the lives of our patients with cancer.
CH: The ASCO Advocacy Summit is a unique opportunity to educate members of Congress and their staff about the current realities of the cancer care delivery system and how their decisions impact real people who have cancer. The support of lawmakers is critical to ensuring that our patients have access to high-quality, affordable cancer care. This is why we feel it is so important that our collective voice be heard on Capitol Hill. A big thank you to all ASCO members who participated in the summit, as well as those who participated virtually, by sending messages to their members of Congress through social media or ASCO's ACT Network.