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Point of View: Administration should reduce barriers for Oklahoma seniors needing innovative cancer care

Tom Coburn
Tom Coburn

Whether you call Manhattan or Muskogee home, American seniors across the country should have access to the most innovative cancer treatments available. That may sound like common sense, but misalignments in our health care system may unintentionally be restricting seniors’ ability to get cancer care based on where they live. The Trump administration, which has a strong record on increasing access to innovative cancer treatments, has the opportunity to remedy this disparity and increase Oklahoma seniors’ ability to receive the most innovative cancer treatments available.

As a physician, lawmaker and cancer survivor, I’ve had the opportunity to see our country’s health care system from a variety of angles. One thing that has remained true throughout my decades of experience is that American medical innovation is allowing people to live longer and healthier lives.

One of the most innovative up-and-coming cancer treatments is an immunotherapy known as CAR-T (Chimeric Antigen Receptor T-cells) therapy. CAR-T therapy takes a cancer patients’ own white blood cells and re-engineers them to fight the cancer. We have seen positive results in clinical trials throughout the country.

Yet many rural Medicare beneficiaries may not have access to this promising treatment. The current doctor and hospital reimbursement process for CAR-T Medicare patients is broken.

These inadequate reimbursements not only create access barriers for patients, but also a disparity between commercial and Medicare cancer patients, and between patients from urban and rural areas.

Take Oklahoma for example. Medical facilities that are capable of performing CAR-T are at a significant disadvantage when it comes to treating Medicare patients because the system does not provide for adequate reimbursement. Only a small group of hospitals across the country are being adequately reimbursed. For Oklahoma’s seniors with cancer, that means they may have to travel to neighboring states to receive care. For a senior facing a cancer diagnosis, the effort and resources it takes to travel may simply be too much. While they should be able to receive care close to home, seniors would be faced with a decision about uprooting their lives to have access to the best medicine available.

The Centers for Medicare and Medicaid Services (CMS) has the opportunity to fix this disparity. CMS and the administration have proven that they value providing broad coverage of CAR-T therapies for Medicare’s seniors. They should continue to support these principles by fixing the CAR-T reimbursement system.

We need a long-term solution that more appropriately reimburses the providers of these innovative treatments, which will in turn provide better access for appropriate seniors on Medicare with cancer. And we must address this before next fall when providers could face a significant drop in reimbursement, therefore further threatening Medicare beneficiaries’ ability to get care.

American seniors should be able to receive the most promising cancer treatments available, regardless of ZIP code. CMS should continue their strong record on medical innovation and patient access issues and enact a long-term solution once and for all.

Coburn is a former physician and senator from Oklahoma. He is founder of the organization Pursuit, which seeks to hold federal agencies accountable for their spending.

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