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Step Therapy in Medicare Part D Oncology Drugs

... Drug Plans (PDPs), to control prescription drug spending. While UM is used to lower plan spending and premiums for beneficiaries, it can also make it more difficult for patients to access the prescriptions they need, especially high-cost oncology drugs. To better understand how UM is used in Medicare, the American Cancer Society Cancer Action Network (ACS CAN) engaged Avalere ... and UM by plan type. Differences in tiering occurred within Special Needs Plans (SNPs), which placed the four drugs on the specialty tier 45% of the time and the preferred brand tier 55% of the time. [1] All non-SNP MA-PDs and all standalone PDPs placed the four drugs on the specialty ...

The Facts About Medicaid and Cancer

Medicaid provides essential health coverage to millions of lower income individuals in the U.S. It is funded jointly by the federal and state governments. Because access to health insurance coverage is a key factor in preventing, catching and treating cancer, the American Cancer Society Cancer Action Network (ACS CAN) encourages policymakers to ensure that this vital health coverage program is available to people who need it, particularly those with cancer ... their Medicaid benefits. [10] The program has encountered significant obstacles, including high administrative costs: the program has already cost nearly $26 million to implement, with 90% of funding directed toward administrative expenses, including application processing and work ...

Survivor Views on Health Care Tax Credits

Overview: The American Cancer Society Cancer Action Network (ACS CAN) empowers advocates across the country to make their voices heard and influence evidence-based public policy change, as well as legislative and regulatory solutions that will reduce the cancer burden. As part of this effort, ACS CAN deploys surveys to better understand cancer patient and survivor experiences and perspectives, through our Survivor Views research panel. The panel is a group of cancer patients and survivors who respond to regular surveys and provide important insights to support ACS CAN’s advocacy work at all levels ...

Survivor Views: One in Ten Impacted by Recent Drug Shortages

Overview The American Cancer Society Cancer Action Network (ACS CAN) empowers advocates across the country to make their voices heard and influence evidence-based public policy change, as well as legislative and regulatory solutions that will reduce the cancer burden. As part of this effort, ACS CAN deploys surveys to better understand cancer patient and survivor experiences and perspectives, through our Survivor Views ... they were a good candidate for it, however most (69%) did not discuss it with their doctor. Nine percent did not have biomarker testing due to cost or coverage concerns. Telehealth Four-in-five agree it is important for cancer patients to have access to telehealth services from out of ...

Understanding Biologic and Biosimilar Drugs

  Biologics basics Biological drugs, commonly referred to as biologics, are a class of drugs that are produced using a living system, such as a microorganism, plant cell, or animal cell. Like all drugs, biologics are regulated by ... Biologics have been a part of medical treatment for a long time and have been used for treating cancer since the 1980s. Biologics can be used to treat cancer in a variety of ways. One way, immunotherapy, helps the body’s own immune system fight cancer cells.  Other ... were introduced Biosimilars were introduced to the market in an effort to increase competition and reduce drug costs. In general, biologics cost more to develop and manufacture than small molecule drugs. They also take a longer time to bring to market (10 to 15 years versus 7 to 10 ...

Survivor Views: Pandemic-Related Challenges Persist for Cancer Patients and Survivors

Overview: The American Cancer Society Cancer Action Network (ACS CAN) gives voice to cancer patients and survivors on critical public policy issues that affect their lives.  As part of this effort, ACS CAN deploys surveys to better understand cancer patients ’ and survivors’ experiences and perspectives, through efforts ... American Indian and Asian or Pacific Islander (44%) were far more likely to have encountered challenges accessing care.  •    The overall cost of health care was identified by over one third of cancer patients and survivors (36%) as the most important challenge to address in order to ...

Survivor Views on Artificial Intelligence and FDA Medical Product Reviews

Overview The American Cancer Society Cancer Action Network (ACS CAN) empowers advocates across the country to make their voices heard and influence evidence-based public policy change, as well as legislative and regulatory solutions that will reduce the cancer burden. As part of this effort, ACS CAN deploys surveys to better understand cancer patient and survivor experiences and perspectives, through our Survivor Views ... Key Findings Eighty percent of cancer patients and survivors agree that the industries making FDA-regulated products should provide some of the cost of FDA’s public health oversight Cancer patients and survivors mirror the American public in their hesitancy to embrace AI, with 51% ...

Choice in Treatment Modality Overwhelmingly Important to Cancer Patients & Survivors

Overview The American Cancer Society Cancer Action Network (ACS CAN) empowers advocates across the country to make their voices heard and influence evidence-based public policy change, as well as legislative and regulatory solutions that will reduce the cancer burden. As part of this effort, ACS CAN deploys surveys to better understand cancer patient and survivor experiences and perspectives, through our Survivor Views ... oral medication report completing visits to their provider within an hour or less, compared to only 17% of those receiving IV infusions 82% say cost is an important factor in their decision when given a choice of treatment options, and 94% agree it is important that patients and their ...

Medicaid Cuts Put People with Cancer at Risk

In 2023 10% of adults with a history of cancer in the U.S. relied on Medicaid for their health care. [i] Additionally, over one-third of children newly ... at 2 years post diagnosis, and the increase was most prominent among non-Hispanic Blacks in rural areas, highlighting how expanding Medicaid can reduce health disparities. [iv]   The American Cancer Society Cancer Action Network opposes cuts to the Medicaid program, as these cuts will ... funding is determined by the Federal Medical Assistance Percentage (FMAP). Today, the federal government pays between 50 and 77 percent of the cost of providing most health services to most Medicaid enrollees, [v]  and a higher percentage for the Medicaid expansion population. If FMAP ...

Threats to Medicaid Funding: Changes to Provider Taxes & State-Directed Payments

Medicaid is a critical source of health insurance and coverage for more than 77 million Americans, including people with cancer who rely on the program for prevention, timely ... The Medicaid program employs a joint financing mechanism that relies on both state and federal funds. To help finance the non-federal portion of Medicaid spending, states are allowed to utilize provider taxes ; these taxes are incurred by providers (hospitals, nursing facilities, etc.) in ... to provider characteristics. Provider taxes are an important funding mechanism for Medicaid, in part because this tax revenue is money the state can use to draw down the federal match and fund its program – and it’s a tax that providers, an important constituency in Medicaid policy, ...

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