Updated
Updated · Fox News · Sep 28
50-Plus Lawmakers Urge CMS to Drop Medicare Drug Rule Affecting Cancer Treatments
Updated
Updated · Fox News · Sep 28

50-Plus Lawmakers Urge CMS to Drop Medicare Drug Rule Affecting Cancer Treatments

1 articles · Updated · Fox News · Sep 28

Summary

  • More than 50 bipartisan lawmakers asked CMS Administrator Mehmet Oz in a Sept. 21 letter not to finalize a proposed fixed-dose combination policy in Medicare’s drug price negotiation rule.
  • The group said the policy could pull improved versions of existing medicines into price negotiations soon after FDA approval, weakening incentives to develop upgraded cancer therapies.
  • Cancer immunotherapy was a central example: lawmakers said newer injectable options can replace hours-long infusions, improving access for patients, especially in rural areas.
  • CMS has framed the proposal as a way to stop drugmakers from making limited changes to older drugs to avoid or delay negotiated Medicare prices under the 2022 Inflation Reduction Act program.
  • The lawmakers also argued FDA already treats those therapies as separate medicines and said CMS actuaries have not shown the policy would deliver meaningful taxpayer savings.

Insights

Could Medicare’s anti-evergreening rule unintentionally discourage faster, easier cancer treatments by treating new formulations like old drugs too soon?
How should CMS tell the difference between a minor drug tweak and a meaningful innovation that improves access, safety, or patient experience?