COA Applauds Technical Fix to IRA Drug Pricing Policy That Threatens Cancer Care

Bipartisan House Legislation Will Protect Patient Access to Cancer and Other Complex Therapies by Preventing Destruction of Independent Medical Practices

WASHINGTON, DC, UNITED STATES, July 9, 2025 /EINPresswire.com/ -- The Community Oncology Alliance (COA) strongly supports the reintroduction of the Protecting Patient Access to Cancer and Complex Therapies Act in the United States House of Representatives. The bipartisan bill, championed by Congressmen Greg Murphy, MD (R-NC-3), Neal Dunn, MD (R-FL-2), and Adam Gray (D-CA-13), addresses a critical flaw in the Inflation Reduction Act (IRA) that threatens to devastate independent medical practices – especially those providing cancer care. It provides a straightforward technical fix to the IRA Medicare drug price negotiations by removing providers from the middle of the pricing equation.

Under the current implementation of the IRA, Medicare reimbursement for certain Part B drugs will be based on the government-set Maximum Fair Price (MFP) rather than the market-based Average Sales Price (ASP) starting in 2028. This shift is projected to slash provider reimbursement by up to 64 percent, creating an unsustainable financial and administrative burden for practices treating patients with cancer and other serious diseases.

“As a physician, Congressman Murphy well understands the numerous pressures that independent medical practices face in keeping their doors open to treating patients. We applaud his leadership, along with Congressman Gray and Congressman Dunn, in introducing the Protecting Patient Access to Cancer and Complex Therapies Act,” said Ted Okon, executive director of COA. “This technical fix to the Inflation Reduction Act will alleviate yet another reimbursement cut and administrative burden that threatens seniors’ access to high-quality, affordable, and accessible cancer care and treatments for other serious diseases.”

The bipartisan bill ensures that Medicare reimbursement to providers continues to be based on ASP while still allowing manufacturers to refund the negotiated savings to Medicare. This approach preserves patient access, avoids chaos in the drug supply chain, and maintains the federal savings promised by the IRA.

Previous Avalere Health studies have shown that the IRA’s current implementation will massively upend practice economics, including a minimum 47 percent cut to provider reimbursement, and as high as 64 percent for certain drugs. This would result in up to $19 billion in lost add-on payments for providers administering just three oncology drugs over a five year period. Additionally, a total of $25–37 billion in revenue loss would be incurred across Medicare, Medicare Advantage, and commercial payers due to ASP erosion from MFP.

The commercial market spillover is particularly alarming. Because ASP is used broadly in private sector reimbursement contracts, changes to Medicare policy could ripple across the health care system – causing even greater instability and threatening access to care beyond Medicare.

The prospect of IRA cuts comes on top of years of declining Medicare reimbursement for community oncology practices. Another Avalere Health study found that Medicare physician payments for oncology services lagged far behind inflation, with the Medicare conversion factor falling by five percent from 2014 to 2023 while inflation rose by 28 percent. Layering the IRA’s drug reimbursement cuts on top of this long-term trend would be devastating – further eroding access, accelerating practice closures, and shifting more care to costly hospital settings.

COA has repeatedly warned that the IRA Medicare drug price negotiations, as written, are a practice-ending event for community oncology and other specialty practices. The Protecting Patient Access to Cancer and Complex Therapies Act offers a common-sense, bipartisan solution that Congress must act on before it’s too late.

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About the Community Oncology Alliance (COA)

The Community Oncology Alliance (COA) is a nonprofit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology, where the majority of Americans with cancer are treated. The mission of COA is to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities. Learn more at www.communityoncology.org.

Drew Lovejoy
Community Oncology Alliance
info@coacancer.org