As both drug prices and out-of-pocket expense for prescription medications continue to climb, a team of Health Policy experts at Vanderbilt University School of Medicine (VUSM) have received a grant to determine if these factors are causing older Americans enrolled in Medicare Part D for medication coverage to delay or never fill their prescriptions.
Dr. Stacie Dusetzina, associate professor of health policy and Ingram Associate Professor of Cancer Research at Vanderbilt, is leading the $550,000, two-year study jointly funded by the Leukemia & Lymphoma Society and The Commonwealth Fund, a private foundation that promotes efforts to support better access and quality of health care for vulnerable populations.
“In this study we will focus on patients who are prescribed specialty drugs, meaning high-priced medications used to treat complex or rare conditions,” said Dusetzina. “We will track price increases and insurance coverage for specialty drugs to understand what health plans and patients are paying and how that has changed over time.
“We will also use data obtained through the National Patient-Centered Clinical Research Network or PCORnet to connect data from a patient’s electronic health record and their Medicare claims. This will allow us to capture both physician prescribing and patient medication filling, as well as some clinically relevant health outcomes for patients.”
The costs for specialty drugs used to treat rheumatoid arthritis, multiple sclerosis, HIV, cancer and hepatitis C will be tracked in the study. The team will also examine the use of health services such as hospitalization and emergency department visits, survival rates and Medicare spending. This data is expected to reveal the association between delaying or never filling a prescription and health outcomes related to the disease being treated.
“Population-level data that connect medication prescribing and medication filling have not historically been available, which has prevented researchers from making correlations between the two in the past,” Dr. Dusetzina said. “Our seniors are a vulnerable population, and many of the drugs included in this study have very high out-of-pocket prices for patients who are starting treatment.
“For example, some cancer drugs can cost patients more than $3,000 for a month of treatment. This would obviously represent a financial hardship for many people, and we think that this may delay appropriate care.
“It is our hope that the results of this project will provide the evidence needed to support federal efforts to better manage prescription drug prices and to identify gaps in Medicare coverage policies for Part D enrollees who are prescribed specialty drugs,” Dr. Dusetzina said.