Lisa Lacasse, the new president of ACS CAN, outlines some of the organization’s priorities for 2019. Previously deputy president at ACS CAN, the American Cancer Society’s advocacy arm, Lisa takes office at a pivotal time concerning public health policy and cancer care for patients, survivors and those at risk for the disease.
OBR spoke with her about what’s on ACS CAN’s radar as she started her new term on February 1, 2019.
OBR: First, congratulations on your new appointment. Where are you going to start? What are some of your priorities for 2019 as you take office?
LL: Policy issues critical to our cancer mission include increasing federal cancer research funding, preserving and increasing access to quality, affordable health care and improving patient quality of life. We also do a lot of work on prevention and early detection of cancer including, tobacco control and access to screening such as mammography and colonoscopy.
Securing funding is one of our most important ways we impact our mission – at both the state and federal levels. While we’ve had significant increases in NIH funding over the last few budgets, maintaining and increasing that funding will be critical to developing promising new cancer diagnostic tests, treatments and therapies. Of course, those new treatments do little good if patients can’t access them because they’re uninsured. ACS CAN has and will continue to strongly advocate in favor of preserving patient access to comprehensive health care through the Affordable Care Act and Medicaid.
Improved patient quality of life through palliative care is also something ACS CAN has and will continue to lead on in the patient community. Ensuring cancer patients get the supportive, coordinated care they need from the point of diagnosis through survivorship is essential.
OBR: ACS CAN, along with 60 other organizations, just launched a national ad campaign voicing opposition to proposed Medicare Part D changes. The proposal threatens 6 protected classes which would negatively impact cancer, and other patients, access to affordable, life-saving therapies. Please elaborate on your concerns regarding the proposed changes and explain what your organization is doing to help defeat the proposal.
LL: The six protected classes policy requires Part D plan sponsors to cover almost all FDA-approved cancer drug therapies. This ensures enrollees can get timely access to the best drugs to treat their disease. HHS is proposing to allow Part D plans to use utilization management, such as step therapy before patients can get access to doctor-recommended drugs, which could result in delayed or suboptimal treatment. Cancer care often requires specialized, non-interchangeable treatment.
The proposed changes would also allow plans to exclude new drug formulations and to eliminate coverage for certain drugs based on price increases. This is incredibly concerning for cancer patients and could result in being unable to access the best treatments at the right time.
ACS CAN is working to make patient concerns clear through formal comments along with a targeted advertising and grassroots efforts to get the Department of Health and Human Services to not move the proposed rule forward.
OBR: The ACA has recently come under attack again with a U.S. District Court ruling that found the entire law invalid. The U.S. Court of Appeals can overturn the ACA, which jeopardizes people with preexisting conditions and would allow health plans to strip essential health benefit coverage for millions. Where do things stand with the latest ruling, and what action is ASC CAN taking on that front?
LL: The ruling is being appealed. ACS CAN along with several other patient groups, filed an amicus brief in the case urging the law be upheld. If the ruling stands, anyone with a pre-existing condition could be charged more for health coverage or denied access to coverage altogether. Health plans would no longer be required to offer essential benefits and could once again impose arbitrary annual and lifetime limits on coverage. Invalidating the law also would jeopardize the federal tax credits that make health insurance affordable for more than 8 million Americans, threatening their access to critical health coverage.
At this point we’re hopeful the Appeals Court will support people with chronic conditions and preserve critical health care for millions of Americans.
OBR: A looming public health crisis is the rising levels of e-cigarette use and vaping among youth and teens. Public health officials and others have called for regulatory and legislative measures to help prevent nicotine addiction and youth initiation into these products. What is ACS CAN’s position on the debate and what are your plans to address the problem?
LL: The surge in youth e-cigarettes use jeopardizes decades of progress we’ve made reducing tobacco-related death and disease. We need the FDA to exercise its full regulatory authority over all tobacco products and conduct the legally required pre-market review of e-cigarettes if we’re going to tackle this epidemic. Unfortunately, the FDA has stopped short of exercising this authority for years.
Last year, we joined our public health partners in filing suit in federal court challenging an FDA decision that is allowing e-cigarettes to stay on the market despite not being reviewed by the agency. In addition to the lawsuit, we will continue to urge the FDA to prohibit the tobacco industry’s use of flavoring in its products, which are clearly used to attract youth to these addictive and deadly products.
OBR: Can you talk about how ACS CAN changed the Congressional dialogue on palliative care and patients’ quality of life from simply focusing on end-of-life care? Is your work done, or what remains to be done to further the discussion on behalf of cancer patients?
LL: Patients and health care providers are increasingly recognizing that palliative care is necessary for patients with serious illnesses like cancer. ACS CAN is a leader in the patient community, advocating for passage of the Palliative Care and Hospice Education and Training Act (PCHETA), which provides funding and infrastructure to raise awareness about palliative care and increase provider training. Through PCHETA, we’ve been able to change the narrative around palliative care beyond end-of-life care to encompass care from the moment of diagnosis.
PCHETA takes a holistic approach to improving patients’ quality of life and would build a robust workforce dedicated to this kind of care. Lawmakers increasingly understand the importance of palliative care for the millions of Americans living with serious illness and at the end of the 115th Congress, the legislation had passed the House and enjoyed broad bipartisan support in the Senate.
ACS CAN staff and volunteers will urge lawmakers to prioritize this important issue and make the legislation a reality in the 116th Congress. The bill has already been reintroduced in the House with support of both Chairman Pallone and Ranking Member Walden.
OBR: We’ve all read about the national opioid crisis, but we also know opioids can benefit cancer patients. What is ACS CAN’s position on these drugs and their access for cancer patients?
LL: ACS CAN recognizes the importance of addressing the national opioid crisis caused by misuse and abuse of opioids. Last year, Congress worked diligently to come up with solutions to curb the epidemic. Throughout that debate, ACS CAN advocated for balanced solutions to the opioid epidemic that would avoid unintended consequences for cancer patients. ACS CAN supported the final bipartisan legislation. We were particularly supportive of provisions to aid development and use of non-opioid medications and bolster prescription drug monitoring programs. We remain devoted to making sure cancer patients’ and survivors maintain appropriate access to necessary pain treatment.