by:rishab$kumar $ $mentor:$dr.$jalpa$doshi,phd · 2019. 12. 17. ·...
TRANSCRIPT
By: Rishab Kumar Mentor: Dr. Jalpa Doshi, PhD
¡ Background § Chronic Disease Problem § Specialty Drugs § Part D Cost Structure
¡ Cost Sharing Study ¡ Multiple Myeloma
§ Background § SAS Analysis
¡ Patient Assistance Programs § Background § Economic Analysis
¡ Conclusion
¡ Chronic Disease is a condition lasting longer than 3 months § It cannot be cured, only treated
¡ About 70% of all deaths are caused by a chronic disease
¡ 80% of the older population has a chronic disease
¡ Cancer is a huge segment of chronic disease
www.wesrch.com
¡ These are mainly called specialty drugs § What is a specialty drug?
¡ Used mainly in chronic conditions ¡ 1% -‐ 5% of people use specialty drugs ¡ They are expensive!
¡ Focuses on the Medicare Population ¡ Evaluates how the current cost sharing plan affects specialty drug use ¡ Rare Diseases
§ CML, RCC, MM
¡ First 30 day fill
2015 Catastrophic Coverage Jan Rest of Jan Feb March April May June
Patient Drug Cost $7,062 $938 $8,000 $8,000 $8,000 $8,000 $8,000 Plan payment $2,157 $141 $1,200.00 $1,200.00 $1,200.00 $1,200.00 $1,200.00
Medicare Payment $0 $750 $6,400.0 $6,400.0 $6,400.0 $6,400.0 $6,400.0 Manufacturer $2071 $0 $0 $0 $0 $0 $0 OOP payment $2,834 $47 $400.00 $400.00 $400.00 $400.00 $400.00
July August September October November December Totals $8,000 $8,000 $8,000 $8,000 $8,000 $8,000 $96,000
$1,200.00 $1,200.00 $1,200.00 $1,200.00 $1,200.00 $1,200.00 $16,871 $6,400.0 $6,400.0 $6,400.0 $6,400.0 $6,400.0 $6,400.0 $71,150
$0 $0 $0 $0 $0 $0 $2071 $400.00 $400.00 $400.00 $400.00 $400.00 $400.00 $7,659
¡ What is Multiple Myeloma? § Cancer of the immune system
¡ Risk Factors ¡ Symptoms
¡ Epidemiology § Rare Disease
¡ Prognosis § No cure
¡ Treatment Options § Chemo § Immunomodulation Agents § Proteasome Inhibitors § Histone Deacetylase Inhibitors
¡ Literature Review § Methods ▪ Ovid, Pubmed, Google
¡ Current research in Multiple Myeloma under this context: § Studies that examine cost § Studies that examine treatment option § Medicare Population
Generic name Brand name Manufacturer Routes Medicare Part D/B
First FDA approval date
FDA Approval date for condition
1 bortezomib Velcade Takeda Pharmaceutical IV/SubQ B/D 2003 May 2003 May
2 thalidomide Thalomid Celgene Corporation oral D 1998 July 2006 May
3 lenalidomide Revlimid Celgene Corporation oral D 2005 Dec 2006 June
5 doxorubicin liposomal Doxil Janssen IV B 1995 Nov 2007 May
6 carfilzomib Kyprolis Amgen IV B 2012 July 2012 July
7 pomalidomide Pomalyst Celgene Corporation oral D 2013 Feb 2013 Feb
8 panobinostat Farydak Novartis oral D 2015 Feb 2015 Feb
¡ Summary of tasks given to me in SAS § State variation
¡ Methods § Importance of drug table § Public Medicare Datasets
data MM_drugs; set partd.partd_prescriber_puf_npi_drug_13; where drug_name in ("VELCADE","THALOMID","REVLIMID","DOXIL","POMALYST", TREANDA“, “FARYDAK”); run;
¡ Help low income people obtain expensive meds § Funding
¡ Types of PAPs § Pharmaceutical § Non-‐Profit
¡ My second task: Obtain as much relevant info on Non-‐Profit as possible
¡ Why focus on the non-‐Profits? ¡ Examples: CDF, PAF, PAN F, LLS, CVC, AF.
§ About 8-‐10 major non-‐profit PAPs ¡ Eligibility
§ Primarily income based ¡ How much do they actually contribute though?
¡ Final thoughts § Chronic disease prevalence § Policy problem § Economic implementation of specialty drugs § More research needs to be done ▪ Patient Outcomes
¡ My team at work § Jalpa Doshi, PhD § Vrushabh Ladage § Alex Pengxiang, PhD § Yasmeen Wermers § Kevin Huang
¡ SUMR Program § LDI, Joanne, Safa § My cohort