Progress Has Eased Burden on Patients With Blood Cancers, but More Change Is Needed, LLS Reports

Currently, more than 1.3 million Americans are living with or in remission from a blood cancer, and by 2020, an estimated $173 billion will be spent on the cost of cancer care. However, there has been progress. A progress report from the Leukemia & Lymphoma Society (LLS) highlighted policy measures that have eased the burden on patients, but also noted where more work is needed.

LLS highlighted the FDA’s push to speed up the review of generic drug applications, HHS’ endorsement of site-neutral payments, and a new law from Congress that closed the donut hole in Medicare Part D as progress that aligns with LLS’ policy agenda.

Read more about cost-sharing burden in patients with blood cancer

Not all the changes have been made at the federal level. Pharmacy benefit managers and electronic health record vendors are initiating collaboration that provides more transparency on drug costs as physicians are prescribing medications. Colorado adopted a policy that requires at least 25% of plans offered by each insurer charge only a flat co-pay for drugs rather than coinsurance.

However, LLS is still pushing for more relief for patients.

“While some headway has been made this year to address increasing out-of-pocket costs faced by cancer patients for their treatments and care, far more action is needed to address the financial toxicity that adds to the stress of a cancer diagnosis for patients and their families,” Louis J. DeGennaro, PhD, LLS’s president and CEO, said in a statement.

Value-based payments are one area where LLS continues to advocate for progress. While several obstacles have been removed as FDA gave new tools to insurers and drug manufacturers to create payment structures based on value, more programs are needed to incentivize value-based care, according to the report.

LLS is also pressing for a cap in Medicare Part D on the amount beneficiaries pay out of pocket to obtain medications. This is a proposal that has bipartisan support among both the Trump administration and Democratic Congressional leaders.

“When cancer patients are fighting for their lives, the last thing they need is financial distress,” said Nichols. “LLS receives thousands of calls each year from cancer patients and their families about financial stress and difficulties accessing treatment. It is clear that we still have a very long way to go to find solutions.”