It’s estimated that over 15,000 Kansans will be diagnosed with cancer this year. For those people with this difficult diagnosis, hope often comes from the promise of innovative new treatments that are getting us closer to a cure. Clinical trials for these promising treatments are taking place across the country every day, and more trials are hopefully coming to Kansas soon. As a physician of over 30 years preparing to conduct a clinical trial for an innovative new cancer treatment known as CAR-T, it’s critical for my patients and their families that the government not hinder access to these treatments by refusing to cover them in community oncology clinics like mine.
The science and technology regarding finding a cure for cancer are evolving by the day, and one of the treatments with the most potential is known as chimeric antigen receptor (CAR) T cell therapy. The key behind this treatment is using the patient’s own immune system to fight the disease. To do this, the patient’s immune system cells are removed, reengineered in a lab to fight cancer, and then returned to the patient to fight the disease. There are already clinical trials for CAR-T being conducted around the country and the results have been promising.
I am currently working with a team of doctors to get a CAR-T trial up and running at the Cancer Center of Kansas, bringing this trial closer to Kansans who may not have the ability to travel far distances to receive this treatment. However, the Centers for Medicare and Medicaid Services (CMS) is currently reviewing a decision on whether or not to cover CAR-T in non-hospital settings like my community clinic. If they would fail to cover this treatment outside of hospitals, the results could be harmful to patients and providers alike.
If CMS decides to not cover CAR-T outside of hospitals, patients could face significant access issues. Battling a disease like cancer is physically and emotionally exhausting, and many patients prefer to receive treatment at a community clinic close to their home and family. In fact, over 80 percent of cancer patients are currently treated in the community setting. Failing to cover CAR-T in non-hospital settings could limit access to treatment for thousands of Americans. On the other side, supporting coverage in these non-hospital facilities will allow this innovation to reach more patients.
Dr. Shaker R. Dakhil
Further, community clinics across the country have already demonstrated that they are capable of administering complex treatments. Each clinic would be required to meet the same safety and reporting standards as hospitals. As long as they are able to achieve these reporting standards, the setting of treatment shouldn’t matter.
Finally, the science behind CAR-T is evolving at a rapid rate. It’s being explored in multiple lines of care and in settings across the country. The government should consider the rapidly evolving technology and potential of CAR-T when making decisions that will impact patients for years to come.
We have been fortunate in that members of the Kansas congressional delegation have taken notice of this issue. Kansas Congressman Roger Marshall, M.D. (R-KS) recently led a letter to CMS urging them to increase access to this therapy. His efforts have helped to bring the importance of this decision to light.
CMS is taking their time with this decision – and that’s largely a good thing. But it’s also important that they issue a decision in a timely manner to provide clarity for providers and better access for patients. This decision is critical, and it’s one that we have to get right.
– Dr. Shaker R. Dakhil is a medical oncologist at the Cancer Center of Kansas.