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Prescription Drug Benefits for Medicare Patients with Cancer to Cost More in 2009
Date:12/12/2008

ded cancer drugs. The Avalere-ACS CAN research found that Gleevec had the largest increase in the number of PDPs requiring prior authorization, with 70 percent of plans requiring it, up from 35 percent in 2006. Tarceva had the next highest increase, with 62 percent of plans requiring prior authorization in 2009, up from 35 percent in 2006. Thalomid was next, with 68 percent of plans requiring prior authorization in 2009, up from 43 percent in 2006.

Geography and plan choice influence how much a person with cancer will spend out-of-pocket in Medicare Part D. Avalere and ACS CAN modeled hypothetical drug regimens for women with breast cancer and found that total out-of-pocket costs for a woman enrolled in AARP MedicareRx Saver in Florida will be about $1,985, while total out-of-pocket costs for beneficiaries enrolled in Humana PDP Standard in California will average about $2,551.

ACS CAN and the American Cancer Society are closely monitoring these issues as part of their nationwide efforts to ensure access to quality, affordable health care for all Americans. The organizations believe that the health care system needs to be retooled with an emphasis on prevention and early detection; meaningful health insurance that is adequate, affordable, available and administratively simple; and reducing pain and suffering with an emphasis on quality of life.

Avalere continues to analyze Medicare drug benefit data. Since the inception of the Medicare drug program, Avalere has used its proprietary DataFrame(R) database to track trends in drug pricing, plan strategy and structure, and the beneficiary experience.

ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national prio
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SOURCE Avalere Health
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