Check out our latest patient profile on the challenge of out-of-pocket costs when it comes to managing HIV/AIDS. Our past profiles have explored other chronic conditions like cancer, rheumatoid arthritis and mental health.
Now, meet Tom. Tom is a 45-year-old, living in Washington. He manages a small dog-walking business where he earns $3,677 a month. Tom purchased a silver plan through the state health insurance exchange with a premium of $339 a month. Tom has also been diagnosed with HIV and uses medication to manage the disease.
Many patients with health insurance exchange coverage are learning about the challenge high out-of-pocket costs present for accessing needed treatments and services. Just last week, two new studies highlighted again that health insurance does not always translate to affordable care. With yearly out-of-pocket costs totaling more than 11 percent of Tom’s income (not including monthly premiums) he is considered underinsured.
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In December 2009, Matt Ellefson received news from his doctor that no one ever wants to receive: a diagnosis of advanced non-small cell lung cancer. He faced a five-year survival rate of less than five percent. Nearly six years later, Matt is not only surviving, but thriving, thanks in part to innovations in cancer medicines.
Stories like Matt’s illustrate that every advance in cancer treatment, no matter how small it may seem, can make a lifesaving difference. And why medicines should not be evaluated based on the projected value they provide to an average patient, but on the value treatments provide to an individual patient. Value is not a simple term to define in cancer care. For some patients, value can mean more time spent with loved ones, an improved quality of life or increased productivity.
I'm Not Average
Nicole Sweeney is a Manager with Boston Healthcare Associates. She focuses on health policy and market access issues faced by innovators in the pharmaceutical, medical device, and diagnostic space.
The American Society of Clinical Oncology (ASCO)’s Annual Conference is this week, and with a theme of “Illumination & Innovation: Transforming Data into Learning” we are excited to see the research being presented on ways to prevent, treat and cure cancer.
In the last several decades, our scientific understanding of cancer has grown immensely, and the U.S. cancer death rate has fallen 22 percent since its peak in 1991. Innovative cancer therapies have played a significant role in this decline; however, the most impactful changes to the care paradigm often emerge from existing therapies through their further evaluation in post-approval clinical studies and real-world data collection. Because accelerated approval is a key pathway to get drugs to patients who need them quickly, the full value of an oncology medicine is typically not known until well after a drug is available to patients.
When we think about innovation in medicine development, we often don’t picture assembly lines or the industrial manufacturing methods that create the tablets, capsules, injectables or I.V. solutions which help patients live healthier, more productive lives.
A new report from Deloitte analyzes recent trends in manufacturing technology innovation, providing new information on how new technologies over the past decade are positively impacting the ability of the biopharmaceutical industry to create new medicines and therapies.
The making of medicines requires significant investment in building high-tech production facilities and equipment that has become central to the ability of manufacturers to align with advances in research and development.
Medicines in Development,
We wanted to take this #MedicareMonday to wish all of you a happy Memorial Day! But we didn’t want to leave you without some Medicare reading for your day by the pool or grilling on the patio, so here’s a look back on what we’ve covered over the last few months:
High Out-of-Pocket Costs Hurt Patients: Even with health coverage, approximately 31 million Americans were considered “underinsured” last year due to high deductibles and increasing out-of-pocket costs, according to a new survey from the Commonwealth Fund. The study found that those with low incomes and/or health problems were at the greatest risk of being underinsured. Read more in a Catalyst post about the survey and check out AccessBetterCoverage.org for information on choosing a plan to meet your needs.
Loretta was diagnosed with Stage 4 lung cancer 12 years ago - but thanks to medical breakthroughs and innovative medicines, she is living a happy, active life today.
Matt was given a five percent chance of living five more years when diagnosed with advanced non-small cell lung cancer - but advances in cancer research changed his prognosis and now he trains for half-marathons.
A new survey from the Commonwealth Fund found nearly a quarter of 19-to-64-year-old Americans with health insurance last year—approximately 31 million people—were considered “underinsured.” Meaning patients had health insurance, but their coverage did not always protect them from high medical bills and major financial issues. The culprit? Increasing deductibles and high out-of-pocket costs.
Key findings from the survey include:
- Adults with low incomes or health problems are at greatest risk of underinsurance and have high rates of medical bill issues: 42 percent of those with incomes below the federal poverty level were underinsured.
- Medical bill and debt problems have long-term financial consequences: Nearly half of survey respondents said they exhausted their savings to pay medical bills, nearly one quarter were dealing with collection agencies and 7 percent had to declare bankruptcy.
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New data raises even more questions about how hospitals are using for-profit pharmacies to expand a little known program called 340B. This program was designed to allow qualifying hospitals and clinics receiving certain federal grants to access deeply discounted pharmaceuticals so they can more easily provide medicines for their uninsured or vulnerable patients.
Unfortunately, there are not sufficient safeguards in place to ensure that hospitals qualifying for the program are true safety net hospitals providing a disproportionate share of charity care to low-income, uninsured patients.
Now, new data shows the majority of hospitals that are aggressively expanding use of this program through for-profit pharmacies are actually providing below average levels of charity care.
Potential personalized medicines represent 42 percent of drugs in the pipeline. This new finding, from a survey by the Tufts Center for the Study for Drug Development (CSDD), is remarkably high, particularly given that about 15 years ago the science of genomic medicine was just developing and that number was virtually zero.
Until recently many believed that biopharmaceutical companies were resistant to personalized (or precision) medicine and were not performing research to advance the field. Critics often speculated that the science was too hard and companies would not consider developing medicines for such small patient populations.