UK HealthCare University of Kentucky College of Pharmacy Lexington, Kentucky
Medications for the treatment of cancer have increased greatly in both complexity and cost over the past decade. The existing healthcare delivery and payment systems have struggled to keep pace with the innovation and complexity. How oncology care is provided is continuing to evolve and has created some site of care shifts. In addition, the coverage design of public payers like Medicare, and benefit design of private insurers has shifted more costs to patients in the form of higher premiums, deductibles, and co-insurance. These and other factors have contributed to the challenges many patients face in obtaining timely access to therapies.
As an array of new drugs continue to come to market with price tags over $150,000 annually, health plans, provider, pharmacies, and patients are forced to consider novel ways to control cost while optimizing access to life saving therapy. This presentation will describe contemporary care and access issues at the regulatory, manufacturer, and patient care level, allowing for a holistic understanding of the value and hurdles of cancer care in America. An overview of drug pricing reforms and Medicare Part D redesign as proposed in the Build Back Better Act will be provided.
Learning Objectives:
Discuss factors impacting patient access to oncology medication therapies with an emphasis on financial toxicity and cost-sharing
Describe best practices for health-system pharmacists in navigating the evolving health care system to optimize patient access to oncology medication therapies
Review regulations impacting manufacturer’s ability to assist patients gaining access to oncology medication therapies
Provide an overview of potential drug pricing reforms and potential impact on improving patient access to medications