The government is proposing dramatic changes to Medicare Part B, including possible cuts to physician reimbursement for many innovative treatments based on the government’s decisions about which treatments are most valuable for seniors. Unfortunately, these decisions would be based on average results across broad populations, ignoring individual patient needs.
As a result, patients who don’t fit the average, like Simon, may have difficulty gaining access to the treatment best for them. For a patient like Simon, diagnosed with late stage and rapidly advancing colorectal cancer, the specific course of treatment has real implications. Simon’s tumor has a specific genetic variant (wild type KRAS), which means he is more likely to respond to specific targeted treatments. Not all treatments are the same, and for Simon, the specific treatment matters.
Assuming that patients should be treated on an average ignores the needs of individual patients, and Simon’s case study is just one example of how this could happen under the government’s proposal.PhRMA.org/PartB.
Allyson Funk Ally is a former senior director of public affairs at PhRMA focused on advocacy issues for the biopharmaceutical industry. Her expertise includes Medicare, Medicaid, 340B, health reform and more. Prior to PhRMA, her experience included leading health communications for a large membership organization, supporting public affairs clients and working for the governor of Louisiana.