Rising Financial Burden of Targeted Oral Anticancer Medications on Medicare Part D Program and Beneficiaries
High costs of oncology drugs have threatened the affordability of cancer care. Previous research using data from privately insured non-elderly cancer patients showed that both the trends of rising prices at launch and of sustained price increase post-launch were more pronounced among targeted oral anticancer medications (TOAMs) compared to targeted intravenous drugs.
One of the poster presentations at the ASCO conference will present data that explores the financial burden of TOAMs on the Medicare program and beneficiaries. For this study, presenters used the SEER linked to Medicare Part D, 2007-2012; determined the list of TOAMs from the National Cancer Institute’s Targeted Cancer Therapy Fact Sheet; and identified TOAM users via the National Drug Code in Part D claims.
The study cohort included 37,117 patients who received TOAM between 2007 and 2012. The top five cancers among TOAM users were lung (33%), myeloma (23%), kidney (8%), liver (7%), and leukemia (7%). While the prescription drugs category of medical care consumer price index (CPI) grew at 3.3% per year in the 2007-2012 duration, gross drug costs of TOAMs increased at 11% per year, reaching $7,704 (median $7,636) cost per patient per month (PPPM) in 2012. Among patients who did not receive subsidies from Medicare or other public insurance, out-of-pocket costs exhibited a non-linear pattern, with the dip in 2011 corresponding to the starting year of “donut hole” closing. Gross drug costs PPPM varied widely by medication, ranging from $4,100 to > $11,000 in 2012.
Ultimately, the growth of of TOAM costs in Medicare Part D program outpaced the growth of prescription drug CPI more than threefold. Rising drug costs of TOAMs not only impose a substantial fiscal burden on the Medicare Part D program, but also threaten the financial relief that the Affordable Care Act intended to achieve for pts by gradually closing the donut hole.
This presentation can be viewed during the Saturday June 4, 1:00 p.m. to 4:30 p.m. poster session.
