Opinion: Congress wastes time with foreign pharma policy

Michael Sapienza

Americans spend more on health care than any other developed nation, and the $3.6 trillion cost last year was more than the gross domestic product of most countries, including the United Kingdom and Canada.

A cancer diagnosis doubles the chances a family will declare bankruptcy, Sapienza says.

The financial burden of health care is especially acute for people with chronic conditions; in fact, today a cancer diagnosis doubles the chances a family will declare bankruptcy.  

This is why the Colorectal Cancer Alliance — the oldest and largest patient advocacy organization dedicated to the prevention of colorectal cancer — strongly supports efforts by Congress to ensure health insurance coverage for all Americans and reducing the cost of treatment for cancer and other chronic conditions.

We are, however, very concerned that the “binding arbitration” concept being considered in Congress will have a negative impact on the ability of colorectal cancer patients and their physicians to select the treatment that provides the best chance of survival and quality of life.  

The “binding arbitration” concept provides that a third party will determine what price Medicare will pay for pharmaceuticals. This approach is utilized by several other countries and has lowered some prices, but it has also resulted in significantly reducing the available treatment options, in some cases by more than 25 percent.

Colorectal cancer, as with most cancers, is a progressive disease in which time is of the essence. Any delay in accessing the optimum treatment can be life-threatening. This is why concepts like fail-first and step-therapy are dangerous when it comes to cancer care; by the time the right treatment is available, it could be too late.

Rather than importing initiatives such as “binding arbitration,” the International Price Index (IPI) model and other programs that have demonstrated reduced access and less effective treatment outcomes for European patients, Congress should seek a comprehensive approach addressing both coverage and lower total health care expenditures.

Pharmaceutical products represent about 10% of health care spending and are increasing at a lower annual rate than both hospital and physician costs. Congress must address the spectrum of all health expenditures, not just the 10 percent attributed to pharmaceuticals.

America is the world leader in innovation and treatment for cancer patients. Congress should seek new American solutions to address rising costs, not failed European models.

Michael Sapienza is the chief executive officer of the Colorectal Cancer Alliance.