Funding for Cures Bill Remains Sticking Point for Health Groups

  • Plan to pay for bill includes cuts to prevention funds
  • House vote expected Wednesday on drug, device innovation bill

U.S. lawmakers finally reached an agreement on legislation to fund cancer research and accelerate new drugs to market. But the plan to pay for the proposal remains a sticking point for some health groups.

The $6.3 billion bill, known as the 21st Century Cures Act, gets more than half its funding by revoking $3.5 billion over 10 years that was supposed to go to a pot of money established under Obamacare to help prevent diseases such as Alzheimer’s and diabetes, increase vaccine use, and raise awareness about the harm caused by tobacco.

“It’s bad public policy, and it really puts prevention at odds with curative treatment,” Georges Benjamin, executive director of the American Public Health Association, said in an interview.

John Meigs, president of the American Academy of Family Physicians, agreed, saying prevention of a disease should get the same consideration as treatments produced by pharmaceutical companies.

“We remain confused and concerned that Congress continues to contribute toward the treatment of disease while depleting resources aimed at preventing disease, ” Meigs said in an e-mailed statement.

Cancer Moonshot

More than a year after the House passed its own version of the bill, House and Senate negotiators managed to reach an agreement just before a new Congress is sworn in. The legislation is headed for a House vote on Wednesday, then is expected to be taken up by the Senate before the end of December, according to Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, a Tennessee Republican.

The proposal provides $4.8 billion for the National Institutes of Health, including $1.8 billion for Vice President Joe Biden’s cancer moonshot. It would also give $500 million for the Food and Drug Administration, and states would get another $1 billion to address opioid addiction. Even though the bill takes funds away from prevention, other groups did praise the agreement, saying it will make a difference for patients and includes prevention efforts.

“In an ideal world we would have liked to not use all that money but this is what we have,” said Ellen Sigal, chairwoman of the Friends of Cancer Research.

Chris Hansen, president of the American Cancer Society Cancer Action Network, said in a statement that the bill has “the potential to greatly accelerate and improve cancer detection and treatment in this country.” He also urged lawmakers to leave intact funding that has already been allocated for the prevention fund “for the explicit and intended purpose to refocus our health-care system on preventive health.”

Obamacare authorized $18.8 billion for the prevention fund between fiscal 2010 and 2022 and $2 billion per year after that, according to the public health association. In 2012, Congress passed a $6.25 billion cut to the fund to offset a scheduled reduction in Medicare physician payments.

Duplicate Efforts

The Cures bill will fund some prevention efforts, said Lynne Weil, a spokeswoman for Representative Diana DeGette, a Democrat from Colorado who helped shape the House’s original version of the measure.

“If you look at the projects that the fund was initially slated to cover, some of them are a little duplicative with existing prevention efforts,” Rachel Sachs, an associate professor at the Washington University School of Law in St. Louis, said in an interview. “Others, it may be that they need less funding.”

The bill would also:

  • Establish an expedited pathway to approval for medical devices the FDA deems breakthrough
  • Directs the FDA to evaluate data collected by use of a drug in the real world to help support approval of a new use of an approved medicine
  • Eliminates federal Medicaid matching funds for prescription drugs used for cosmetic purposes or for hair growth, unless they’re determined to be medically necessary
  • Allow the FDA to accept conditional approval of regenerative, or stem cell, therapies, to get them to patients faster and allow manufacturers to prove benefit while the product is on the market

— With assistance by John Lauerman

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