Administration preserves patient access to certain medications

On March 6, 2014 the Cancer Policy Institute at the Cancer Support Community (CSC) submitted a letter to the Centers for Medicare & Medicaid Services (CMS) raising concerns about how a proposed change in policy could hinder cancer patients’ access to certain types of medication.  In response to the concerns of CSC and many members of the patient advocacy community, on March 10, 2014, CMS announced that they have withdrawn their proposed changes.

Under current law, CMS identifies six categories of medications as “protected classes”.  Medicare beneficiaries who take medicine to treat their cancer, have medical conditions which require them to take anti-seizure medicine, are HIV-positive, need to take immunosuppressant drugs or have a mental health condition for which they are prescribed antidepressants or antipsychotics are all guaranteed coverage for any of these medicines.  CMS had proposed to remove protected class status for three of these classes of drugs – immunosuppressant drugs, antidepressants and antipsychotics.  CSC and other patient advocates wrote to CMS to share their concerns that if this policy was instituted, patients may experience increased burden, uncertainty and delays in treatment if they couldn’t easily access the drugs prescribed by their physician.

As a nonprofit organization that provides direct services, research and works to improve the quality of care patients with cancer receive, CSC focuses on the importance of treating both the mind and body in order to improve patient outcomes.  Up to half of all patients with cancer experience distress, approximately 15-25% experience depression and about 16% are prescribed an antidepressant.  Furthermore, data from CSC’s Research and Training Institute shows the leading cause of distress for those living with cancer is a disruption to a patient’s work or family life routine.  CSC was concerned that the proposed regulation could have interfered with patient access to certain kinds of medication and negatively impact people with cancer.

CSC thanks CMS for not changing its current policy and thereby preserving Medicare beneficiaries’ full access to these special categories of medicines—people with cancer and other complex medical conditions need seamless access to life-saving and life-stabilizing prescription drugs.  The full comment letter, in addition to other cancer coalition letters supported by CSC can be found by clicking here.

If you have questions or concerns regarding your own cancer journey, please call CSC’s Cancer Support Helpline at 1-888-793-9355. We are ready to answer your call and assist you with any cancer-related issues.


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