[Congressional Record Volume 149, Number 69 (Friday, May 9, 2003)]
[Senate]
[Pages S6000-S6001]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself, Mr. Rockfeller, Mr. Warner, Mr. 
        Hollings, Mr. Kerry, Ms. Collins, Mr. Carper, Mr. Allen, Ms. 
        Landrieu, Mrs. Lincoln, Mr. Fitzgerald, Mr. Dorgan, Mr. 
        Corzine, Mr. Campbell, Mr. Schumer, Mr. Chafee, Mr. Smith, Mr. 
        Harkin, Ms. Mikulski, Ms. Cantwell, Mr. Nelson of Nebraska, Mr. 
        Craig, Mrs. Feinstein, and Mr. Lautenberg):
  S. 1037. A bill to amend title XVIII of the Social Security Act to 
provide for coverage under the Medicare program of all oral anticancer 
drugs; to the Committee on Finance.
  Ms. SNOWE. Mr. President, I rise today to introduce, the Access to 
Cancer Therapies Act, which will extend Medicare coverage for all oral 
anticancer drugs. This legislation will help ensure that Medicare 
beneficiaries with cancer have access to the most advanced and 
effective drug therapies. I am pleased to be joined today by 19 of my 
colleagues in introducing this legislation. The strong bipartisan 
support the bill has received, even before introduction, indicates its 
importance to members of the Senate.
  As we know, presently Medicare does not include an outpatient 
prescription drug benefit. While this is a tremendous hardship for all 
beneficiaries, it is especially difficult for seniors who have cancer, 
which prevents them from receiving the most appropriate drug treatments 
as recommended by their physicians.
  Enacting a comprehensive Medicare drug benefit is certainly one of my 
top priorities. However, even if we are successful and enact a bill 
into law this year, the comprehensive benefit is not expected to be 
available until 2006 at the earliest. This bill, on the other hand, 
would allow Medicare to begin coverage of oral anticancer drugs within 
90 days of enactment. These patients are facing life and death choices, 
I believe it is our responsibility to provide access to the most 
effective and appropriate drug therapies.
  Congress recognizes the importance of expanding coverage to vital 
cancer treatments and in 1993 created a unique Medicare drug benefit 
for oral anti-cancer drugs. Unfortunately, coverage under this law only 
is provided if the drug is equivalent to drugs provided ``incident'' to 
a physician visit; for example, drugs that must be injected. At 
present, upwards of 95 percent of cancer drug therapy is covered by 
Medicare either in a physician office or as an oral form, which 
qualifies under the 1993 legislation. However, in the very near future 
as much as 25 percent of cancer drug therapies will be oral drugs not 
covered. By enacting this legislation into law, we can ensure these new 
outpatient cancer treatment therapies will be available to Medicare 
beneficiaries.
  This is a developing trend. Today, there are about 40 oral anti-
cancer drugs, but less than 10 are reimbursed by Medicare. In fact, one 
of the most common and effective drugs used in the treatment of breast 
cancer, tamoxifen, is among those drugs that currently are not 
reimbursed by Medicare.
  As cancer therapy becomes more reliant on oral drugs, Medicare 
coverage policy must be updated to cover the new therapies. Otherwise 
the intent of the very limited 1993 policy will become meaningless and 
Medicare beneficiaries will increasingly lose access to the best cancer 
therapies.
  Let me provide some very encouraging examples of oral anti-cancer 
drugs that illustrates the urgency of both this policy change and of 
enacting Medicare prescription drug legislation. Over the past two 
years, the FDA has approved a number of remarkable oral anticancer 
drugs that are producing outstanding results. Two such examples include 
Gleevec, which was approved in 2001 and IRESSA, which was approved on 
May 5.
  Gleevec is used to treat one type of leukemia and may also be 
effective against a rare but lethal stomach cancer. It is the first, 
let me repeat, first, cancer drug to specifically address a molecular 
target, which not only is in the cancer, but actually is the cause of 
the cancer, according to the National Cancer Institute. More precisely, 
Gleevec eliminates a specific enzyme needed for the cancer to thrive. 
By contrast, most current cancer therapies act like a shotgun, killing 
both cancer and normal cells.
  IRESSA, another revolutionary oral anticancer drug that the FDA 
recently approved, treats advanced non-small-cell lung cancer, NSCLC. 
Considering lung cancer is the leading cause of cancer deaths in the 
United States, estimated to account for approximately 157,000 deaths in 
2003, and NSCLC is the

[[Page S6001]]

most common form of lung cancer, accounting for 80 percent of all lung 
cancer cases, it is imperative that Medicare beneficiaries have access 
to this new drug. For many who do not respond to chemotherapy 
treatments, IRESSA is the last line of defense.
  However, both of these cancer treatments are expensive. For instance, 
while Gleevec is a revolutionary and highly effective treatment, it is 
not a cure. It simply arrests the cancer and returns most lab tests to 
normal, requiring many patients to take the drug for life. Considering 
the extraordinary costs of these treatments--a month's supply of 
Gleevec costs upwards of $2,400 and IRESSA, the last treatment option 
for many NSCLC patients, costs approximately $1,900 per month of 
treatment, with the average treatment lasting seven months--Medicare 
coverage is a necessity.
  It is imperative that Medicare provide reliable access to these 
advanced medications to help beneficiaries with cancer. Biomedical 
research is providing new, more targeted, and less toxic methods of 
treatment through new oral anti-cancer drugs that patients can safely 
take in the comfort of their own homes, which will help improve 
outcomes and enhance patient quality of life.
  We must act now to ensure all oral anti-cancer drugs are available to 
our seniors. The Access to Cancer Therapies Act will build on current 
Medicare policy by ensuring coverage of all anti-cancer drugs, whether 
oral or injectable, are available to Medicare beneficiaries. The Act 
will provide beneficiaries with access to innovative new therapies that 
are less toxic and more convenient, more clinically effective and more 
cost-effective than many currently covered treatment options. I urge my 
colleagues to support this bill.
  Mr. ROCKEFELLER. Mr. President, I rise today to introduce a small 
bill, but one with important consequences. My measure, the ``Access to 
Cancer Therapies Act,'' would provide coverage of all oral anti-cancer 
drugs under the Medicare program. I am pleased to join Senator Snowe in 
introducing this measure.
  As my colleagues know, there is no Medicare outpatient prescription 
drug benefit today. If there was, we would not need this legislation. 
There should be and there must be a meaningful and fair Medicare 
prescription drug benefit this year. Seniors are reeling from the 
burden of their prescription drug expenses, and they can't defer their 
illnesses or their costs.
  This legislation also reminds us of how crucial prescription drug 
coverage will be in the future. In 1993, Congress created a unique 
Medicare drug benefit for oral anti-cancer drugs--but only if the drug 
is equivalent to drugs provided ``incident'' to a physician visit; for 
example, drugs that must be injected. At present, upwards of 90 percent 
of cancer drug therapy is covered by Medicare either in a physician 
office or in a reimbursed oral form. But by 2010 as much as 25 percent 
of cancer drug therapy will be in the form of oral drugs that are not 
currently covered.
  As cancer therapy moves more toward reliance on oral drugs, Medicare 
coverage policy must be updated to cover the new therapies, or else 
even the intent of this very limited policy will be meaningless and 
Medicare beneficiaries will increasingly lose access to the best cancer 
therapies. And without this legislative change, beneficiaries will 
increasingly bear the burden of buying these drugs from their own 
pockets, which most seniors can ill-afford.
  While biomedical research is providing new, more targeted, and less 
toxic methods of treatment through new oral anti-cancer drugs that 
patients can safely take in the comfort of their own homes, Medicare 
policy is currently unable to provide reliable access to these 
medications for beneficiaries with cancer.
  This legislation is important not only to seniors surviving cancer, 
but to all Americans. A recent poll conducted for the National 
Coalition of Cancer Survivorship found that 9 out of 10 Americans 
believe that Medicare should pay for all medically approved cancer 
therapies.
  Even if we do not succeed in enacting a comprehensive Medicare drug 
benefit this year, it is time to do what Americans want for cancer 
survivors by passing the Access to Cancer Therapies Act in the 108th 
Congress. This legislation gives people with cancer immediate access to 
life-saving drugs. This is a stop-gap provision that would be phased 
out when a comprehensive Medicare drug benefit is put into place that 
would cover oral anti-cancer drugs consistently with all other drugs.
  At the very least, we must ensure all oral anti-cancer drugs are 
available to our seniors. The Access to Cancer Therapies Act will build 
on current Medicare policy by ensuring coverage of all anti-cancer 
drugs, whether oral or injectable, are available to Medicare 
beneficiaries. The act will provide beneficiaries with access to 
innovative new therapies that are less toxic and more convenient, more 
clinically effective and more cost-effective than many currently 
covered treatment options. In the last Congress, 57 Senators 
cosponsored this bill. This is an opportunity to improve our Medicare 
program immediately. I urge my colleagues to support this bill.
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