Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.
New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.
For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher copayment for drugs than for some other medical services.
Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.