Ted Okon Highlights the 3 Top Legislative Priorities for COA

There are 3 legislative priorities for the Community Oncology Alliance (COA) that keep the focus on the patient and ensure better care, explained Ted Okon, executive director of COA, at the 2018 Community Oncology Conference.

Transcript

What issues are currently top of mind for the Community Oncology Alliance that it is advocating for on behalf of members?

I will tell you right now, and we’ve made this really clear at [the COA annual meeting]: first of all, the focus is on the patient. As I say all the time, and it’s the God’s honest truth, when I forget that, I have to go home to my wife, who is an oncology nurse to remind what this is about: it’s about patients. And it’s a stark reminder all the time. So, what we’re focused on, we’re focused on things like PBMs [pharmacy benefit managers] and PBMs that are delaying medication, in some cases switching medication without the provider involved. I spoke to a hundred advocates the other day, and I asked everybody to raise their hand who has been impacted by a PBM or a specialty pharmacy not getting their medication on a timely basis. Virtually every hand went up. So, that’s a top priority for COA on behalf of patients.

The other thing is 340B. We’re seeing not only the idea that 340B hospitals are strong-arming practices to merge—and, of course, when that happens, patients pay more—but we’re actually seeing the patients that are turned away from 340B safety-net hospitals, because they have insufficient insurance. What’s the purpose of 340B, in the first place? That is just really wrong.

The other thing that’s really high up on our list now, is prior authorizations. The amount of time that a provider has to be on the phone with an insurance company and others, PBMs, in terms of justifying the kind of care that that patient should have, and it is clearly standard of care, is just intolerable. What’s the effect on the patient? The effect on the patient is: the patient is not getting their medical care on a timely basis. And the other thing is, the providers are sucked away to dealing more in terms of data entry and being on the phone, as opposed to being in front of the patient. So, this is a real problem.

In these 3 issues: PBMs and 340B and also prior authorizations, it’s literally all first and foremost, and it has to be—and I get reminded—about the patient. We have some other issues. We’re dealing with the VA [Department of Veterans Affairs] on cancer care now. We’re still working on the sequester cut. We’re very involved in oncology drug payment reform, with the OCM [Oncology Care Model] and elsewhere. But legislatively, those are 3 of the biggest issues that we have on the docket right now at COA.