As we’ve learned in recent case studies, the specific course of treatment chosen for a patient managing a serious disease can have real implications for their quality of life. Patients and their physicians must weigh the pros and cons to determine the best treatment option to meet their individual needs.
However, sometimes health coverage may prevent patients from receiving personalized treatment, instead forcing patients to follow one-size-fits-all standards of care. For Mary, a patient living with severe rheumatoid arthritis, her coverage delayed her access to the treatment preferred by her physician that would have allowed for better adherence and the ability to work. Instead, when forced to abide by a one-size-fits-all standard, her quality of life suffered.
Unfortunately, the Medicare Part B Drug Payment Model, proposed by the Centers for Medicare & Medicaid Services, may force more patients like Mary to receive one-size-fits-all treatments instead of the right personalized treatment – hurting the overall quality of care Medicare patients receive.
Learn more about the tradeoffs of personalized treatment vs. one-size-fits-all standards in our other case studies:
- Joyce, diagnosed with stage IV metastatic breast cancer;
- Simon, diagnosed with late stage and rapidly advancing colorectal cancer; and
- Susan, diagnosed with schizophrenia.
Nicole Longo Nicole is director of public affairs at PhRMA focusing on Medicare, 340B, importation and more. She previously worked for a D.C.-based public affairs firm where she assisted a wide range of clients with communications efforts on everything from trade policy to agriculture policy to health care policy. Outside the office, Nicole can be found trying new restaurants (usually Italian), taking an occasional barre class and cheering on the Cincinnati Bengals.