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Impact of Subsidies on Use of Immunomodulatory Drugs in Medicare Beneficiaries With Myeloma

By: Meg Barbor, MPH
Posted: Monday, September 11, 2017

Medicare Part D beneficiaries with myeloma and without a low-income subsidy will likely face barriers to affording their oral immunomodulatory medications, according to research published by Adam J. Olszewski, MD, of Rhode Island Hospital, and colleagues, in the Journal of Clinical Oncology. The low-income subsidy substantially lowers out-of-pocket costs for qualifying Medicare Part D beneficiaries who receive orally administered chemotherapy.

The investigators identified Part D beneficiaries diagnosed with myeloma between 2007 and 2011. Among 3038 beneficiaries, 41% received first-line immunomodulatory drugs. Median out-of-pocket cost for the first prescription was $3,178 for patients without a low-income subsidy, and $3 for subsidy recipients, whereas respective median costs for the first year of therapy were $5,623 and $6, respectively.

Among beneficiaries 75 to 84 years of age, receipt of the low-income subsidy was associated with a 32% higher probability of receiving immunomodulatory drugs. Subsidy recipients in all age groups also had a significantly lower risk of delays between refills.

“Medicare beneficiaries with myeloma who do not receive low-income subsidies face a substantial financial barrier to accessing orally administered anticancer therapy, warranting urgent attention from policymakers,” the investigators maintained. “Limiting out-of-pocket costs for expensive anticancer drugs, like the immunomodulatory drugs, may improve access to oral therapy for patients with myeloma.”