![Page 1: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/1.jpg)
By: Rishab Kumar Mentor: Dr. Jalpa Doshi, PhD
![Page 2: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/2.jpg)
¡ Background § Chronic Disease Problem § Specialty Drugs § Part D Cost Structure
¡ Cost Sharing Study ¡ Multiple Myeloma
§ Background § SAS Analysis
¡ Patient Assistance Programs § Background § Economic Analysis
¡ Conclusion
![Page 3: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/3.jpg)
¡ Chronic Disease is a condition lasting longer than 3 months § It cannot be cured, only treated
¡ About 70% of all deaths are caused by a chronic disease
¡ 80% of the older population has a chronic disease
¡ Cancer is a huge segment of chronic disease
![Page 4: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/4.jpg)
www.wesrch.com
![Page 5: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/5.jpg)
¡ These are mainly called specialty drugs § What is a specialty drug?
¡ Used mainly in chronic conditions ¡ 1% -‐ 5% of people use specialty drugs ¡ They are expensive!
![Page 6: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/6.jpg)
![Page 7: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/7.jpg)
![Page 8: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/8.jpg)
![Page 9: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/9.jpg)
¡ Focuses on the Medicare Population ¡ Evaluates how the current cost sharing plan affects specialty drug use ¡ Rare Diseases
§ CML, RCC, MM
¡ First 30 day fill
![Page 10: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/10.jpg)
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 $7,659
![Page 11: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/11.jpg)
¡ What is Multiple Myeloma? § Cancer of the immune system
¡ Risk Factors ¡ Symptoms
![Page 12: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/12.jpg)
¡ Epidemiology § Rare Disease
¡ Prognosis § No cure
¡ Treatment Options § Chemo § Immunomodulation Agents § Proteasome Inhibitors § Histone Deacetylase Inhibitors
![Page 13: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/13.jpg)
¡ Literature Review § Methods ▪ Ovid, Pubmed, Google
¡ Current research in Multiple Myeloma under this context: § Studies that examine cost § Studies that examine treatment option § Medicare Population
![Page 14: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/14.jpg)
Generic name Brand name Manufacturer Routes Medicare Part D/B
First FDA approval date
FDA Approval date for condition
1 bortezomib Velcade Takeda Pharmaceutical IV/SubQ B/D 2003 May 2003 May
2 thalidomide Thalomid Celgene Corporation oral D 1998 July 2006 May
3 lenalidomide Revlimid Celgene Corporation oral D 2005 Dec 2006 June
5 doxorubicin liposomal Doxil Janssen IV B 1995 Nov 2007 May
6 carfilzomib Kyprolis Amgen IV B 2012 July 2012 July
7 pomalidomide Pomalyst Celgene Corporation oral D 2013 Feb 2013 Feb
8 panobinostat Farydak Novartis oral D 2015 Feb 2015 Feb
![Page 15: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/15.jpg)
¡ Summary of tasks given to me in SAS § State variation
¡ Methods § Importance of drug table § Public Medicare Datasets
data MM_drugs; set partd.partd_prescriber_puf_npi_drug_13; where drug_name in ("VELCADE","THALOMID","REVLIMID","DOXIL","POMALYST", TREANDA“, “FARYDAK”); run;
![Page 16: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/16.jpg)
![Page 17: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/17.jpg)
![Page 18: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/18.jpg)
![Page 19: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/19.jpg)
![Page 20: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/20.jpg)
¡ Help low income people obtain expensive meds § Funding
¡ Types of PAPs § Pharmaceutical § Non-‐Profit
¡ My second task: Obtain as much relevant info on Non-‐Profit as possible
![Page 21: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/21.jpg)
¡ Why focus on the non-‐Profits? ¡ Examples: CDF, PAF, PAN F, LLS, CVC, AF.
§ About 8-‐10 major non-‐profit PAPs ¡ Eligibility
§ Primarily income based ¡ How much do they actually contribute though?
![Page 22: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/22.jpg)
![Page 23: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/23.jpg)
![Page 24: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/24.jpg)
![Page 25: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/25.jpg)
¡ Final thoughts § Chronic disease prevalence § Policy problem § Economic implementation of specialty drugs § More research needs to be done ▪ Patient Outcomes
![Page 26: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/26.jpg)
¡ My team at work § Jalpa Doshi, PhD § Vrushabh Ladage § Alex Pengxiang, PhD § Yasmeen Wermers § Kevin Huang
¡ SUMR Program § LDI, Joanne, Safa § My cohort
![Page 27: By:Rishab$Kumar $ $Mentor:$Dr.$Jalpa$Doshi,PhD · 2019. 12. 17. · These$are$mainly$called$specialty$drugs$! What$is$a$specialty$drug?$! Used$mainly$in$chronic$conditions$! 1%$O$5%$of$people$use$specialty$drugs$!](https://reader035.vdocument.in/reader035/viewer/2022071413/610c8e2d47cce71c8a06faf6/html5/thumbnails/27.jpg)