[SLIDES] The Promise (and Unfulfilled Promise) of Medicaid Expansion for Vulnerable Populations
Harold Pollack, PhD, MPP
Helen Ross Professor of Social Service Administration, University of Chicago
In this presentation, Dr. Pollack reviews the accomplishments to-date of Medicaid expansion for public health, particularly in the areas of mental and behavioral health. He also explores ways that the Affordable Care Act must be augmented to more effectively advance population health.
[SLIDES] Specialty Pharmacy and the Vulnerable Patient from the Health-System Perspective
JoAnn Stubbings, MHCA
Assistant Director of Specialty Pharmacy Services, University of Illinois at Chicago
Specialty pharmacy models in health-systems are relatively new. This presentation describes a health-system based integrated specialty pharmacy practice model that serves a vulnerable patient population. The model links patient care in the specialty clinics with prior authorization, medication assistance, case management, and medication dispensing to facilitate patient access to medications. Preliminary metrics and outcomes are presented.
[SLIDES] Does the 340B Program Reach Communities in Need, and How Do Prescription Dispensing Patterns Compare to General Outpatient Dispensing?
Bobby Clark, PhD, MSPharm, MHA, MS, MA
Senior Director of Health Outcomes & Clinical research, Walgreens Co.
It is of significant national policy debate whether and how current 340B covered entities serve the original mission of the program to (1) serve the nation’s most vulnerable populations and (2) provide comprehensive services. Furthermore, significant current policy debate examines whether and how 340B qualified contract pharmacies serve the program’s mission to allow eligible healthcare providers to capture savings generated by the 340B program and direct those savings into expanded care for indigent and underserved patients. This study is the first contemporaneous, nationwide examination of whether 340B qualified covered entities and contract pharmacies serve poor, uninsured and medically needy populations. This study is also the first to describe national 340B qualified prescriptions compared to all prescriptions dispensed in the contract pharmacy setting.
[SLIDES] Pricing in the Market for Anticancer Drugs
Rena Conti, PhD
Assistant Professor in Hematology/Oncology, University of Chicago
Drugs like bevacizumab ($50,000 per treatment episode) and ipilimumab ($120,000 per episode) have fueled the perception that the launch prices of anticancer drugs are increasing over time. Using an original dataset of 58 anticancer drugs approved between 1995 and 2013, we find that launch prices, adjusted for inflation and drugs’ survival benefits, increased by 10%, or about $8,500, per year. We present several explanations for these trends, including generous third party coverage that insulates patients from drug prices, the presence of strong financial incentives for physicians and hospitals to use novel products, and the lack of therapeutic substitutes. We argue that under these conditions, manufacturers are able to set the prices of new products at or slightly above the prices of existing therapies, giving rise to an upward trend in launch prices. Government-mandated price discounts for certain classes of buyers may have also contributed to price increases as firms sought to offset the growth in discount segment by setting higher prices for the rest of the market.
[SLIDES] Financial Toxicity in Oncology
Jonas de Souza, MD
Assistant Professor of Medicine, University of Chicago
Cancer is the second most expensive disease in the United States, next to heart disease, with estimated annual costs of $263.8 billion in 2010. Direct costs accounted for $102.8 billion, while $20.9 billion were related to indirect morbidity costs (cost of lost productivity due to illness), and $140.1 billion for indirect mortality costs (cost of lost productivity due to premature death). However, beyond professional organizations and policy makers discussing the value of cancer care, including cost and efficacy (or effectiveness), an essential component of the value equation is seldom measured: the impact of these costs or financial toxicity on patients and their caregivers. A reason for this knowledge gap is that there is no validated instrument to quantitatively measure it. Recognizing that there have been increasing efforts aimed at enhancing patient-centered care and incorporating patients’ voice into clinical practice, Dr. de Souza’s research seeks to fill this gap by developing and validating a financial toxicity patient-reported outcome measure (PROM) in cancer.