Dr. Peter Bach, an oncologist at Memorial Sloan-Kettering Cancer Center in New York, is calling for a radical revamp of Medicare's cancer drug payment program. "The current financing method for physician-administered oncology drugs is unsustainable," he writes in an online Viewpoint on the Journal of the American Medical Association website.
Oncology practices currently operate by charging a mark-up on the retail sales price of chemotherapy drugs. Previously set at 6%, the federal budget sequester dropped that to 4.2%, and the CMS is talking about further lowering it to 3% to hold down costs as the price of the latest cancer drugs soars. The average sales price system provides oncologists with bigger margins if they choose the most expensive drugs, which they are under increasing pressure to do because of the cuts. Responding to oncologists' protests, at least 91 sponsors in the U.S. House of Representatives have signed onto legislation restoring the 6% mark-up.