From November 11-15, delegates from the Association for Clinical Oncology (ASCO) participated in the 2022 Interim Meeting of the American Medical Association’s (AMA) House of Delegates (HOD). The AMA HOD is the principal policy-making body of AMA and meets twice a year to discuss pressing issues and establish policies the AMA uses when setting their advocacy priorities.
ASCO led three resolutions during the meeting and cosponsored a fourth. All four resolutions passed.
- Criminalization of Pregnancy Loss as the Result of Medical Treatment: ASCO called on the AMA to advocate that pregnancy loss as the result of medically necessary treatment should not be criminalized for physicians or patients, and also called on AMA to advocate against civil penalties. Each year, one in 1,000 pregnant people are diagnosed with cancer, and there are patients who become pregnant after being diagnosed with cancer. Some treatments and diagnostic services can harm a fetus or cause serious birth defects, and some cancer therapies should not be used at any state of pregnancy. In the wake of the Dobbs v. Jackson Supreme Court decision in June 2022, a growing number of state laws insert government into the patient-physician relationship by dictating limits or bans on reproductive health services, including some that aim to criminally punish physicians who provide services that result in the loss of pregnancy. This resolution was co-sponsored by the American Society for Radiation Oncology (ASTRO) and American Society of Hematology (ASH). This aligns with AMA’s policies to protect medical judgment from being criminalized and preserving access to reproductive health services.
- Fertility Preservation: ASCO called on the AMA to advocate that “fertility preservation services” include the cryopreservation of embryos, in addition to sperm and oocytes, and urged AMA to advocate against the prosecution of physicians for eliminating or transporting unused embryos. Individuals of child-bearing age face unique challenges related to their treatment because of the effects many anti-cancer treatments can have on the reproductive system. Many payers deem fertility preservation as not medically necessary and either limit or exclude coverage of this benefit, which make this service inaccessible for many patients with cancer. These issues are particularly acute in populations already facing access to care issues, including Medicaid beneficiaries. ASTRO and ASH also co-sponsored this resolution.
- Domestic Production of Personal Protective Equipment (PPE): Additionally, ASCO called on the AMA to support state and federal incentives to locate the manufacturing of goods used in healthcare and healthcare facilities in the United States (US) and urged the AMA to support Administration efforts to encourage the purchase of domestically produced PPE. In early 2021, the Biden Administration issued an executive order directing the development of a strategy to design, build and sustain a long-term capability in the US to manufacture supplies for future pandemics. In July 2022, CMS proposed a policy to incentivize hospitals to purchase and utilize domestically produced N95 masks. ASCO has previously recommended that the Executive Branch identify raw materials, components, parts or accessories of critical devices that should have domestic manufacturing capacity.
- Third-Party Pharmacy Benefit Administrators: Finally, ASCO co-sponsored a resolution introduced by the American College of Rheumatology to call on AMA to advocate that third-party pharmacy benefit administrators, also considered specialty drug management organizations, fall under the existing pharmacy benefit manager (PBM) regulatory framework and statute, and require licensing, registration, and transparency reporting for these entities.
Prior to the opening session, ASCO led a meeting of the HOD's Cancer Caucus, which provides a forum to address cancer-specific issues that are either being discussed or should be discussed by the HOD. The meeting also included robust discussions around diversity and inclusion in medicine, cancer prevention, and other ASCO priority issues.
There are three delegates and three alternate delegates representing ASCO in the AMA HOD: Steve Y. Lee, MD; Kristina L. Novick, MD; and Ray D. Page, DO, PhD, FACOI, FASCO serve as ASCO delegates and Edward P. Balaban, DO, FACP, FASCO; Thomas A. Marsland, MD, FASCO; and Erin L. Schwab, MD, MPH, BS serve as alternate delegates. ASCO’s Resident Fellow Section Delegate is David Savage, MD, PhD and Barbara McAneny, MD, FASCO also participates with the delegation.
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