Stacie Dusetzina Profile picture
Health services researcher at Vanderbilt Health Policy. Avid coffee drinker, investigator of drug policies & prices. RT not an endorsement. Opinions are mine.

May 4, 2022, 8 tweets

💊💊 New Tweetorial Alert 💊💊
Please take a break from your #doomscrolling and read this thread. If you have an even longer break read the paper @NEJM: nejm.org/doi/full/10.10… 1/7

This paper is about #PartD & cancer. It is also about #pharmacoequity (shoutout @UREssien). Not the way we typically think about equity, though. This is about how screwed you are if you need cancer treatment and your treatment happens to be covered by #PartD and not #PartB. 2/7

Half of cancer drugs are covered by #PartD. Whether you get a pill versus infusion is based on your cancer type or subtype. For #breastcancer the preferred regimens for #HER2+ cancer are infused (#PartB); for HER2-, ER/PR+ cancer preferred regimens include a #PartD drug. 3/7

For #Medicare beneficiaries who need the #PartD drugs as part of their cancer treatment, most are going to have to pay $3,000 for their first fill of the drug. They then pay 5% coinsurance for every other fill. This adds up. 4/7

The median income for older adults in the US is low, but many still don't get subsidies in Medicare. In fact, a woman making the median income (~$22K in 2019) would NOT qualify for subsidies and would pay HALF of her income for just one anticancer drug on #PartD. 5/7

For those needing #PartB drugs, most people have some form of subsidies to lower their costs. So, the difference between affording and not affording cancer treatment in #Medicare is whether your cancer drugs are pills or are infusions. This is ARBITRARY and INEQUITABLE. 6/7

There is a lot going on now, but @SenateDems & @SenateGOP this needs to be fixed. #Medicare beneficiaries are counting on you to make sure that they can afford the drugs they need. We know that 1 in 3 people in #PartD don't fill their cancer drugs. That is unacceptable. 7/7

Huge thanks to @commonwealthfnd @Arnold_Ventures and @LLSusa for their support for this work!

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