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Executive Summary Escalating drug costs in the United States are placing pressure on both the federal government and health plans to implement strategies aimed at controlling drug expenditures and optimizing utilization. Utilization management (UM) tactics are ...   SNPs provide the same Medicare Parts A and B coverage for beneficiaries as other MA plans but also offer tailored benefits and coordinated care for beneficiaries that have specific health conditions or meet other requirements. Step Therapy in Medicare Part D Oncology Drugs ...

... note at end). The margin of sampling error associated with a sample of this size is +/-2.8% at a 95% confidence level.  Key Findings: Cancer care is expensive and prescription drug costs are a challenge for nearly one-third of cancer patients and survivors (31%), with one-fifth having ... the survey. For this survey, a patient navigator was defined as follows: “Patient navigators help guide patients through the often-complicated health care system with the resources they need to get care. A patient navigator helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care. Patient navigators may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social ...

Executive Summary Utilization management (UM) refers to a variety of practices that health plans and pharmacy benefit managers employ to confirm the use of specific drugs or services aligns with the payer’s policy. Plans can use ... necessary, or to limit utilization of high-priced, specialty medications. UM use in oncology may have unintended consequences to patient care, such as delaying patient access to medication or increased administrative burden for the patient and provider. Prior to 2019, Medicare ...

... to the composition of clinical trials. Four-in-five (79%) say it is important that a drug they are prescribed has been tested in people whose health is similar to theirs, with 57% saying this is very important and 22% somewhat important. Similarly, 76% agree that it is important the drug ... important that a drug is tested in patients who share their gender. Nationality, race, and ethnicity are viewed as somewhat less important than health condition, age, and gender when it comes to trial diversity, though still important. Fifty-seven percent say it is important the drug has ... affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We stand with our volunteers, working to make cancer a top priority for policymakers in cities, ...