ππ New Tweetorial Alert ππ
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/10.10β¦ 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
Are you feeling down because the drug that you take isn't on the list that @CMSGov just released for price negotiations in #PartD? FEAR NOT. You also get to benfit from negotiation. Let me explain how. 1/4
Medicare negotiations will save the program a ton of money. That money is actually being used, in part, to pay to expand the #PartD benefit to make it better for enrollees. The benfit will be redesigned in 2025. What does that mean for you or your loved ones on #PartD? 2/4
It means that even if your drug ISN'T NEGOTIATED, you still get to benefit. If you take an expensive cancer drug, today it costs over $10,000 out-of-pocket every year on Part D. In 2025 there will be a $2,000 cap on ALL DRUG SPENDING in Part D. That is huge savings! 3/4
ππTWEETORIAL ALERT!! ππ
Because last week was a busy week for #insulin tweets, @KhrystaBaig and I have saved this Tweetorial for our new @JAMA_current paper for a...um...less busy time. AHEM, remember? π Follow along, will you? 1/10
The #SeniorSavings Model allows plans to cover insulin at $35 copays with every fill. But in 2021 and 2022 you had to enroll into a plan to get $35 insulin. If you didn't pick a Model participating plan, you could have paid too much! 3/10
ππTWEETORIAL ALERTππ
New work out this evening in @NEJM@NEJMPerspec on the plan to redesign #Medicare#PartD and how much savings there might be for people enrolled in the program! This has been a moving target (I'm looking at you #BuildBackBetter)! I've got you covered! 1/7
I calculated savings relative to the 2022 benefit for the top 15 highest spending drugs in Part D for the major bills introduced that aimed to redesign the program. None are an exact fit, but HR3 is maybe the closest given the $2000 cap. Some details are still unknown. 2/7
You might remember headlines like this one that were telling us about companies coming out with generic versions of their $$$$ brand-name drugs. We saw this for #insulin#hepatitisC and #epipen over the past few years. 2/7 nytimes.com/2019/03/04/heaβ¦
These are "authorized generics" which are when a brand company takes off the brand name but the drug is exactly the same. In these cases, the generic product came out way before patents were expired. 3/7
Last week my mom was diagnosed with metastatic (stage IV) breast cancer. As someone who has worked in the pharmaceutical industry, studies cancer drug prices, and is trained as a health services researcher, I have some thoughts to share about our current system. 1/10
First, #Cancer sucks. Metastatic cancer is something I hope you never have to say to or hear from someone that you love. When it is you, or your loved one, you desperately want more time. You want good quality of life, and you need for them to live. 2/10
The subtype of cancer tells you what treatment options you have in this really awful situation. If you have orally administered options or infused options, for example. Some subtypes have great targeted therapies that extend life and "are well tolerated". 3/10
Our big finding: If you need a lot of drugs or some very expensive drugs you would save more money out-of-pocket by using brands instead of generics. 2/10
Yeah, that's right. That doesn't make sense.
This happens because branded drug companies pay discounts in the doughnut hole that count as out-of-pocket spending. Generic drug makers donβt. 3/10