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August 4, 2022

Reforming Patient Cost Sharing for Cancer Medications in Medicare Part D

Author Affiliations
  • 1Cancer Innovation and Regulation Initiative, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Division of Urological Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 4Department of Health Policy andVanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA Oncol. Published online August 4, 2022. doi:10.1001/jamaoncol.2022.2828

Medicare has one of the most burdensome patient cost-sharing structures for prescription medications in the US. Under Medicare Part D, which covers outpatient prescription drugs, there is no limit to out-of-pocket costs for most beneficiaries, and a substantial portion of out-of-pocket costs is calculated as a percentage of list prices (coinsurance) rather than fixed co-payments. This cost-sharing system places the burden of escalating list prices of cancer medicines on patients, which is associated with reduced medication adherence and negative health outcomes.1

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