Out-of-Pocket Costs for Prostate Cancer Medications Substantially Vary by Medicare Part D Plan: An Online Tool Presents an Opportunity to Mitigate Financial Toxicity.
Out-of-Pocket Costs for Prostate Cancer Medications Substantially Vary by Medicare Part D Plan: An Online Tool Presents an Opportunity to Mitigate Financial Toxicity.
复制标题
DOI：
10.1097/upj.0000000000000421
复制
发表时间：
2023-09
期刊：
影响因子：
0.8
通讯作者：
中科院分区：
文献类型：
--
作者：
晚期前列腺癌患者经常服用苯扎鲁胺或阿比特龙，通常需要较高的自付费用(OOP)。其中许多患者通过联邦医疗保险参保，并有权在54种不同的D部分药物计划中进行选择。然而，只有不到30%的患者报告在选择计划之前比较成本。一个在线的Part D计划导航器是公开可用的，允许患者比较估计的OOP处方成本。在这项研究中，我们检查了基于前列腺癌患者现有的D部分药物计划的OOP成本的变异性，并演示了在线工具如何为患者节省数千美元。我们使用在线Medicare Part D计划查找器确定了2023年可供选择的药物计划。我们对美国境内12个不同邮政编码的计划选项进行了抽样。大学赞助的癌症专科药房和在线邮购药房也被包括在内，以供比较。我们根据所有可供选择的D部分计划确定了苯扎鲁胺和阿比特龙的OOP成本。平均而言，每个邮政编码有24个D部分药物计划。苯扎鲁胺和阿比特龙的年OOP成本中值分别为11,626美元和9,275美元。苯扎鲁胺的OOP年成本范围为9854美元至13,061美元，阿比特龙为1,379美元至13,274美元。在某些邮政编码内，潜在的OOP成本节省为2,512美元的苯扎鲁胺和9,321美元的阿比特龙。苯扎鲁胺和阿比特龙的OOP成本中位数差异为8758美元。在D部分药物计划中，OOP成本差别很大。Medicare Part D计划查找器是识别负担得起的药物计划的简单而有效的工具。对方案选择的指导可以为患者节省数千美元，并有助于减轻治疗的经济毒性。综合性癌症中心可以包括计划导航器，作为治疗的基本组成部分。
Patients with advanced prostate cancer are frequently prescribed enzalutamide or abiraterone, often requiring high out-of-pocket (OOP) costs. Many of these patients are insured through Medicare and have an option to select among 54 different Part D drug plans. However, less than 30% of patients report comparing costs before selecting a plan. An online Part D plan navigator is publicly available and allows patients to compare estimated OOP prescriptions costs. In this study, we examine the variability of OOP costs based on available Part D drug plans for patients with prostate cancer and demonstrate how an online tool could save patients thousands of dollars. We identified drug plans available for selection in 2023 using the online Medicare Part D Plan Finder. We sampled plan options for twelve different ZIP codes within the United States. A university sponsored specialty cancer pharmacy and online mail-order pharmacy were included for comparison. We identified OOP costs for enzalutamide and abiraterone based on all Part D plans available for selection. On average, 24 Part D drug plans were available for each ZIP code. Median annual OOP costs were $11,626 for enzalutamide and $9,275 for abiraterone. The range of annual OOP costs were $9,854 to $13,061 for enzalutamide and $1,379 to $13,274 for abiraterone. Within certain ZIP codes, potential OOP cost savings were $2,512 for enzalutamide and $9,321 for abiraterone. Median difference of OOP cost between enzalutamide and abiraterone was $8,758. OOP costs vary considerably across Part D drug plans. The Medicare Part D Plan Finder is a simple and effective tool to identify affordable drug plans. Guidance on plan selection could save patients thousands of dollars and help mitigate the financial toxicity of treatment. Comprehensive cancer centers could include plan navigators as an essential component of treatment.