Leaders of the top three federal agencies that deal with the cancer problem spoke at ASCO’s July Legislative Conference, and all organized their remarks around the theme of collecting, paying for, and acting on the wealth of data they currently have or will acquire. Centers for Medicare & Medicaid Services (CMS) Administrator Mark McClellan, MD, PhD, Director of the National Cancer Institute (NCI) and acting Commissioner of the U.S. Most oncologists are familiar with the CMS 2005 Oncology Demonstration Project, which was the initial topic brought to the table by McClellan. This 1-year, $300 million project was designed in part to mitigate the reimbursement reduction for Part B drugs under the Medicare Modernization Act of 2003 (MMA).
The demonstration project payment was intended not only to make up for the reduction in the transition payment from 32% in 2004 to 3% in 2005, but also to compensate physicians for collecting and providing CMS additional, symptom-related data. Oncologists participating in the project, officially called the Demonstration of Improved Quality of Care for Cancer Patients Undergoing Chemotherapy, are reimbursed for collecting data on pain, fatigue, and nausea and vomiting related to chemotherapy. The early data also indicate that severe degrees of these symptoms affect a low percentage of patients: 2% of patients had substantial (“quite a bit” or “very much”) nausea and vomiting, 8% had a similar level of pain, and 26% had a similar level of fatigue.
ASCO encourages its members to remain up to date with changes in the clinical trials system and on issues in drug safety (see Online Resources).