Recommendations to Reduce Out of Pocket Costs for People with Cancer Detailed in New ASCO Position Statement

Strategies Include Cost-Sharing Reductions and Part B Caps During Active Treatment, Ending Co-pay Accumulator Programs

Alexandria, Va.-January 23, 2025-The American Society of Clinical Oncology (ASCO) released a new position statement today detailing recommendations for health care stakeholders to reduce the heavy financial burden people with cancer face when trying to fund their care.

ASCO's recommendations include reducing or capping patient cost-sharing in Medicare Part B and Affordable Care Act (ACA) Marketplace plans, ending the co-pay accumulator programs that increase patient costs for prescription drugs, and ultimately eliminating out-of-pocket costs for active cancer treatment. Specific recommendations include:

• Stakeholder efforts aimed at the ultimate elimination of out-of-pocket costs for active cancer care
• Eliminating copay accumulator adjustment programs in public and private insurance plans
• Requiring that patients' cost-sharing for prescription drugs be based on the same rebated net price that their payer uses
• Implementing a cap on Part B co-insurance, as is already in place for Part D, for patients undergoing active cancer treatment
• Providing further cost-sharing reductions for patients enrolled in ACA Marketplace plans during active cancer treatment
• Directing the Centers for Medicare & Medicaid Services to adjust the maximum out-of-pocket limit for ACA covered plans to prevent cost-sharing for patients undergoing active cancer treatment
• Ensuring that patient assistance programs remain a viable safety net for patients who need access to high-cost anticancer therapies

"Rising out-of-pocket costs are a proven barrier to receiving appropriate and needed care for people with cancer, including those with health insurance," said ASCO President Robin T. Zon, MD, FACP, FASCO. "Even with the existing limits on out-of-pocket costs, patients with cancer are more likely than people without a cancer history to report cost-related delays and reductions in prescription filling, use of less medication, or skipped medication doses-all of which jeopardize the outcome of their cancer treatment."

ASCO is committed to advancing policies that improve patient access to high-quality, equitable cancer care. The Society will continue to work with all stakeholders to address this barrier and ultimately improve cancer care for the people who need it.

Read ASCO's position statement on out-of-pocket costs for cancer care.

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About the Association for Clinical Oncology

The Association for Clinical Oncology (ASCO®) is a 501 (c)(6) organization that represents nearly 50,000 oncology professionals who care for people living with cancer. Established by the American Society of Clinical Oncology, Inc. in 2019, ASCO works to ensure that all individuals with cancer have access to high quality, equitable care; that the cancer care delivery system supports optimal cancer care; and that our nation supports robust federal funding for research on the prevention, screening, diagnosis, and treatment of cancer. Learn more at www.ascoassociation.organd follow us on Twitter at @ASCO.