Managed Care

 

Seventy-five percent of cancer drugs covered under Medicare Part D

MANAGED CARE January 2007. © MediMedia USA
The Formulary Files

Seventy-five percent of cancer drugs covered under Medicare Part D

MANAGED CARE January 2007. ©MediMedia USA













Seventy-five percent of cancer drugs are covered by Medicare Part D plans, with regional MA-PDPs (Medicare Advantage prescription drug plans) covering 85 percent.

Researchers at Avalere Health stratified the universe of cancer drugs covered by each Part D plan by contract type (local MA-PDP, regional MA-PDP, and stand-alone PDP). Prior authorization is the most common cost-limiting tool applied to brand-name cancer drugs, and PDPs and local MA-PDPs use prior authorization more frequently than regional MA-PDDs do. "Plans' use of policies such as prior authorization must be carefully monitored to ensure that cancer patients receive timely and appropriate treatment," says Jennifer Bowman, director and lead researcher of the study.

Cancer drug coverage by Medicare Part D plan types

Source: Bowman J, et al. Health Affairs. 2006;25(5):1240–1248.

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014