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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Hwang TJ, Kesselheim AS, Dusetzina SB. Reforming Patient Cost Sharing for Cancer Medications in Medicare Part D. JAMA Oncol. Published online August 04, 2022. doi:10.1001/jamaoncol.2022.2828
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