AACI Commentary

About Our Editorial Series

Exploring Topics of Interest to AACI Cancer Centers

To promote the work of its member centers, AACI publishes Commentary, an editorial series focusing on major issues of common interest to North American cancer centers. 

Each AACI Commentary is written by a cancer center leader and distributed by email to the more than 2,200 readers of the AACI Update newsletter. 

The publication is designed to cover a specific topic in 750-1,000 words. Recommendations for topics and authors are encouraged. 

Please submit suggestions to: 

Chris Zurawsky
Director of Communications and Public Affairs

Emily Stimmel
Communications and External Relations Coordinator

March 2019

Ensuring Patient Access to CAR T Therapy

AACI Responds to CMS Medicare Coverage Proposal
By Richard Bondi and Clint Divine
There is currently no national Medicare policy for chimeric antigen receptor T-cell (CAR T) therapies—which can cost hundreds of thousands of dollars, well beyond the means of most patients—leaving coverage decisions to regional Medicare administrative contractors. In February, the Centers for Medicare & Medicaid Services (CMS) released its proposed National Coverage Analysis for CAR T therapy.

With nearly half of AACI cancer centers approved to provide CAR T therapies by early 2018, the growing demand for such treatment is posing administrative challenges for AACI member centers. To establish best practices, AACI launched a CAR T Initiative in fall 2018. Prior to the initiative’s formalization, AACI submitted public comments to CMS regarding its proposed national coverage analysis. In March, the initiative’s administrative barriers working group approved final comments on CMS’ coverage proposal, adapted from comments from the American Society for Transplantation and Cellular Therapy (ASTCT), an organization that AACI has collaborated with through the working group.  

It is vital that access to CAR T therapy for Medicare patients is not hindered, but rather expanded. Beyond presenting a burden to patients, many of the components of CMS’ national coverage determination (NCD), as proposed, may cause undue stress for AACI member centers that provide these life-saving therapies because of the rapid advancements being made to develop new CAR T therapies. It is AACI’s view that it is too early to implement the NCD. However, should CMS proceed with implementing an NCD, AACI has compiled several recommendations for consideration.

Read the March 2019 Commentary.
Learn more about the AACI CAR T Initiative.

Zip Code vs. Genetic Code: Breaking Down Cancer Disparities in Philadelphia
By Karen E. Knudsen, PhD
October 2017

Satisfaction with Oncology Quality and Clinical Operations: A survey from the AACI Physician Clinical Leadership Initiative (PCLI)
By Morgan Dodson, Michael Neuss, Laura Hutchins, Richard Lauer, John Sweetenham, Nathan Levitan, Martha Mims, Mohammed Milhem, Craig Bunnell, Dan Mulkerin, Randall F. Holcombe
Fall 2017

SF CAN: A City Working Together to Fight Cancer 
By Alan Ashworth, PhD, FRS
Summer 2017

Integrating Clinical Research into Clinical Care
By Martha Mims, MD, PHD & Sarah McNees, PHD
Spring 2017