Precision Patient Assistance Programs to Enhance Access to Clinically Indicated Therapies: Right Drug, Right Time, Right Cost-Share
Precision Patient Assistance Programs to Enhance Access to Clinically Indicated Therapies: Right Drug, Right Time, Right Cost-Share Cost-Sharing and its Consequences Consumer cost-sharing for medical care and medications is high and getting higher. The average deductible for employer-sponsored single coverage increased by more than 250% between 2006 and 2016, and is now nearly $1,500.1 Even after any applicable deductible has been satisfied, patients are often liable for high copayments and coinsurance. The average copay or coinsurance for a fourth-tier drug in employer-sponsored coverage was $102 in 2016. In 2016, more than 25% of Medicare beneficiaries spent 20% or more of their income on out-of-pocket health care costs,2 with a significant share of this spending devoted to coinsurance of 25-33% for specialty medications. Most Medicare Part D beneficiaries taking a single specialty drug will pay no less than $2,000 over the course of one year[a].3 For Medicare Part [...]