Updates from Washington Impacting Community Oncology Practices

At the 2023 Clinical Pathways Congress + Cancer Care Business Exchange, Nicolas Ferreyros, managing director, Community Oncology Alliance spoke as part of the panel titled "Updates from Washington.” In this interview, he summarizes some of the latest developments from Washington that are impacting cancer care and providers in community oncology.

Transcript:

Nicolas Ferreyros: My name is Nicolas Ferreyros. I'm managing director of the Community Oncology Alliance.

Please give a brief summary of the session you participated in at the Clinical Pathways Congress + Cancer Care Business Exchange.

Nicolas Ferreyros: Our panel was talking about the latest issues from Washington and how they're impacting cancer care and cancer providers. There's a lot going on in Washington right now from the Inflation Reduction Act to new changes in Stark Law around delivery of drugs and PBM reform. So there's a lot happening and our goal was to give folks a little update as well as a reality check on what's possible.

What are some of the most important developments from Washington that you expect will have a major impact on community oncology practices?

Nicolas Ferreyros: In the 118th Congress, which is going on right now, I think the biggest issues that we're facing are pharmacy benefit manager reforms. PBMs previously were really sort of an unknown in Congress, and this year we've seen a sea change on that. Now we go into offices and they're suddenly understanding of the problems and issues and challenges that they may face. So, Congress is really looking at that. We're tracking about 20 bills on PBM reform right now, and it's a very real possibility that we're going to see some progress on them this year. 

What were some of the key takeaways from the session?

Nicolas Ferreyros: I think one of the key takeaways from our session is that there's a lot happening in Congress right now, and despite all of the confusion and gridlock that might happen from leadership challenges or government shutdowns, there's a very real possibility that we're going to see some progress on key issues like PBMs, hospital payments 340B, and other major public policy issues.

How will practices be impacted by the Inflation Reduction Act?

Nicolas Ferreyros: Practices could potentially be tremendously impacted by the Inflation Reduction Act. One thing that people don't really understand is that the IRA negotiated drug price that will turn into the MFP, or maximum fair price, will impact average sales price, or ASP. So, we've done an analysis and that showed that the ASP plus six add-on payment can be reduced as much as 43% for practices. These days with practices, all the other cost inputs and challenges they're facing, that would be an astronomical hit to them. So, practices really need to pay attention to the implementation of IRA, and how these drug price negotiations roll out.

Why should oncology stakeholders be involved in policy and advocacy?

Nicolas Ferreyros: It's critical for everyone in the oncology ecosystem to be part of policy and advocacy efforts because if you are not at the table advocating for your interests and your issues, you are on the menu. And it's quite likely that what they're talking about is ways to address all of the systemic problems without your perspective and your input. So, you need to be a part of policy, you need to be a part of advocacy because if you are not, you'll be left behind.

What do you think will have the most impact on cancer care in the next year?

Nicolas Ferreyros: I think there are a lot of factors that will most impact cancer care in the next year. The Inflation Reduction Act, drug price negotiation implementation is obviously a big one, pharmacy benefit manager reform, also a huge one. And then continued growth of the 340B drug pricing program. We're seeing that going 20 plus percent year over year in compounded annual growth rates. It is really completely unsustainable. And so all of those issues, plus I could go on and on, are going to tremendously impact oncology and cancer practice.