Many Medicare beneficiaries without low-income subsidies do not fill high-price specialty drug prescriptions, new research shows.
For the four conditions studied — cancer, hepatitis C, immune system disorders, and hypercholesterolemia — researchers found that noninitiation "was nearly twice as frequent among those without subsidies." For beneficiaries with cancer who did not have subsidies, almost 30% of initial prescriptions for specialty oncology drugs went unfilled.
The reason: These drugs can cost 100 times more for patients who don't receive a subsidy.
"The out-of-pocket expenses for an initial fill of a high-price drug is typically hundreds or thousands of dollars for an enrollee without a low-income subsidy versus less than $10 for a beneficiary with a full low-income subsidy," Stacie Dusetzina, PhD, Vanderbilt University Medical Center, Nashville, Tennessee, and colleagues say.
The study was published online in the April issue of Health Affairs.
Failing to initiate treatment occurs often; it is estimated that more than 20% of all prescribed medications go unfilled. However, studies that evaluate noninitiation of newly prescribed, high-priced drugs are rare and are limited in scope.
Dusetzina and colleagues sought to understand barriers to noninitiation of high-price specialty drugs covered under Medicare Part D in four disease areas, known for particularly costly medications — cancer,
