ASH Clinical News ACN_4.14_Full Issue_web | Page 75

CLINICAL NEWS Medicare Part D Beneficiaries With Myeloma Receive Novel Therapies More Frequently, Have Better Survival People with myeloma who have prescrip- tion drug coverage under Medicare are less likely to use older cytotoxic chemo- therapy and more likely to receive newly approved therapies, compared with pa- tients who are not enrolled in Medicare. Enrollment in a Medicare Part D plan (PDP) or through a supplemental plan also was tied to better survival outcomes, according to a study published in the Journal of Clinical Oncology. “Our results highlight the increasing need to provide financial guidance and discuss economic repercussions of cancer therapy with patients, particularly those with hematologic malignancies treated with expensive oral antineoplas- tic agents,” lead author Adam J. Olszewski, MD, of Brown University told ASH Clinical News. “If access to all treatment options at diagnosis is associated with survival outcomes (as we have observed), then we can expect emergence of significant disparities depending on site of care.” “Our results have important implications for clinicians ... and for health- care policy.” —ADAM J. OLSZEWSKI, MD Traditional Medicare plans covered only parenteral chemotherapy, poten- tially limiting patients’ access to newer, more effective oral therapies like the immunomodulatory drugs (IMiDs) lenalidomide and thalidomide or the proteasome inhibitor ixazomib. In 2006, the Centers for Medicare and Medicaid Services enacted the PDP drug benefit, which allowed benefi- ciaries to obtain prescription coverage through employer-sponsored plans or federal employee or veterans’ benefits, collectively referred to as other credit- able coverage (OCC). To determine how these drug benefits affected access to therapies, receipt of therapy, and survival among Medicare beneficiaries, the research- ers obtained patient data from 9,755 Medicare enrollees who were diag- nosed with myeloma between 2006 and 2011. All patients were enrolled in a Medicare Part A/B plan before diagnosis for at least a year prior to diagnosis. Coverage status at diagnosis was as follows: • No prescription drug coverage (n=1,460; 15%) ASH Clinical News 73