Legislative Update: Week of August 12, 2019
Two years after CAR-T therapies were approved by the FDA, CMS on Monday announced that they would increase hospital reimbursements for the additional costs of CAR-T therapies, from 50% to 65%. Then, on Wednesday, CMS issued a national coverage determination for CAR-T, meaning the treatment will be covered everywhere when provided in healthcare facilities that have programs in place to track patient outcomes. Prior to this determination, CAR-T coverage was based on local determination so various hospitals in some parts of the country would not get reimbursed at all.
ICER announced on Tuesday that it has proposed changes to its framework for evaluating the value of a drug to address cell and gene therapies and keep pace with technology. Under ICER’s previous framework, drugs were evaluated based on efficacy over time, or the “QALYs” (quality adjusted life years) they provided a patient. Now, they are looking to consider other elements as well, such as drug risks, advantages, and potential impact on future treatments. The proposed changes are open to public comment through September 6, and ICER will have a meeting September 17 to gain additional input.
In Massachusetts, MassDOT released a study on traffic congestion in the Commonwealth. The study looks at where, when, and why congestion occurs in Massachusetts, the areas most susceptible to the worst congestion, and provides recommendations for the future. One of the more prominent recommendations is a proposal to study the feasibility of adding “managed lanes” to highways in which commuters would pay a toll to be able to travel at a quicker pace and have faster commutes.
The MBTA’s Fiscal and Management Control Board meets on Monday to discuss updates on its Red and Orange Line program, commuter rail performance, and the Green Line extension project. Also on the agenda are measures to discuss various station construction projects and design. This meeting follows the recent, unprecedented MBTA proposal that will close eight Orange Line stations from Tufts Medical Center to Sullivan Square for six straight weekends in October and early November, and six Red Line stations from Broadway to Kendall Square for four weekends in late November and early December. Closures are expected to take place along the B and C branches of the Green Line as well.