More Medicare Part D plans and commercial insurers are requiring higher levels of coinsurance for specialty drugs, which affects cancer patients, according to Dan Klein of the Patient Access Network Foundation.
(PRWEB) February 27, 2015
In recent years, after the FDA approved therapies like sipuleucel-T to treat hormone-refractory prostate cancer, or ipilimumab to treat metastatic melanoma, patients who were candidates for these treatments faced both the prospect of longer-term survival, but also the question: how do I pay for it?
As access to insurance coverage increases, and more life-extending immuno-oncology therapies pass muster with FDA, the gap between what science can do and what patients can afford has created challenges for everyone: providers, payers, policymakers, and most of all, patients. Fortunately, the Patient Access Network (PAN) Foundation helps patients narrow that gap, by giving the under-insured financial support to meet cost-sharing requirements for breakthrough therapies.
In the recent issue of Evidence-Based Oncology, a publication of The American Journal of Managed Care, PAN Foundation President and CEO Dan Klein authored a commentary that discussed the foundation’s mission, promising scientific developments, and the changing cost-sharing burden—as therapies are prescribed for much longer periods of time.
As Klein reports, the need is growing “as more Medicare Part D plans and commercial insurers are requiring a higher percentage (25 to 33 percent) of coinsurance for specialty drugs.” While this means patients may qualify for catastrophic coverage sooner, Klein writes, these benefit design changes also mean that some patients won’t have access to the best cancer therapies, and others will have poor adherence for cost reasons.
About the Journals
The American Journal of Managed Care celebrates its 20th year in 2015 as the leading peer-reviewed journal dedicated to issues in managed care. Other titles in the franchise include The American Journal of Pharmacy Benefits, which provides pharmacy and formulary decision-makers with information to improve the efficiency and health outcomes in managing pharmaceutical care, and The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.
CONTACT: Mary Caffrey (609) 716-7777 x 144