Program Coordinator Medication Assistance Program Smilow Cancer Hospital at Yale New Haven
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1 Program Coordinator Medication Assistance Program Smilow Cancer Hospital at Yale New Haven
2 Yale MAP Program Consists of 5 FTE s Has been established for five years Was originally mirrored from the Ohio State James Cancer Center Program- Columbus, Ohio
3 FY 2014 Recovered $2.3 Million in Hospital Replacement drugs. Obtained $6.3 Million in free patient take home medications. Obtained $650,000 in copay grants, used to pay toward clinic infused drugs and take home medication copays.
4 Pharmaceutical Companies Responsibilities & Ethical Issues Responsibilities: Manufacturing safe drugs. Manufacturing drugs that show clinical effectiveness for indicated disease states. Ethical Issues: Ability for all patients to have access to their drugs without limiting access. Establish supportive resources for their patients in an attempt to help increase adherence.
5 Cost Factors in Drug Pricing The cost to bring an oncology drug to market can be in excess of $1 Billion dollars. The value of human life is difficult to justify in a dollar amount. The Medicare Reform Act of 2003 forbade Medicare from negotiating drug prices.
6 Facts The average cancer drug price for approximately 1 year of therapy or a total treatment duration was less than $10,000 before 2000, and had increased to $30,000 to $50,000 by In 2012, 12 of the 13 new drugs approved cancer indications were priced above $100,000 per year of therapy Light DW, Kantarjian(2013) Market spiral pricing of cancer drugs. Cancer 119:
7 Average Patient Out of Pocket Cost for oncology drugs in their treatment The 2013 average out of pocket expense of a commercial plan patient for oncology medication 2. IV $5643 Oral $2838 This cost is in addition to the patients other expenses: Additional copays: prescriptions, physicians Loss of wages during treatment Travel cost to treatment: gas, parking, public transportation Daycare/Eldercare 2.Herper, M,Forbes (2015) Pharma & Healthcare. IMS Real-WorldData
8 Office of Inspector General's (OIG) mission is to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program beneficiaries.
9 Regulation in Pharma Why do some pharmaceutical companies seem to be patient friendly and others do not seem as patient focused? Conformability level with their free or copay drug programs and perception to the OIG.
10 Trial vouchers Ability to start a patient on therapy without delay
11 Approved on 8/11/2015 HHS office of OIG states no sanction of anti-kickback in voucher use To receive the drug through the Free Supply Program, a patient must meet the following criteria: Be a new patient; Receive a prescription for the drug; Have an on-label diagnosis; Have health insurance coverage through a private insurer or Federal health care program; and Have experienced a delay in a coverage determination of at least five days.
12 Brand vs. Generic With non-insured patients Brand drugs can offer a free program that generic drugs might not have. This is helpful in high cost generics. Example is Genentech's Xeloda vs. Teva Generic
13 Foundations-Updates PAF (Patient Advocate Foundation) now has instant approval for grants in the appropriate disease funds. Ovarian Fund is now available through PAF- $7,500 per year. (This fund will have greater funding in 2016). PAF has a new phone App. Funds for treatment transportation are available
14 Best Practices Smilow Cancer Hospital at Yale-New Haven Hospital coordinated the first time ever multi -drug company symposium for innovated practices in Medication Assistance Programs. Attendees at this meeting were decision makers for the Pharmaceutical Companies Medication Assistance Programs.
15 Amgen AbbVie AstraZeneca BMS Celgene Genentech Lilly Novartis Companies That Attended
16 Topics of the Meeting One universal website and application process for oncology medications operated by a third party. One universal copay card for all oncology drugs. Elimination of income criteria for copay programs. Increase in income criteria for other medication assistance programs.
17 Addition
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