Payers’ speed bumps harm patients — and are likely to get worse 

More than 75% of cancer patients must overcome an initial rejection for their medication, regardless of payer channel, tumor type, or drug administration mode, according data compiled by IQVia. Only half of Medicare patients fill a new prescription for an oral oncology medication within 30 days of the initial attempt, and about 40% abandon the prescription, foregoing treatments for serious and life-threatening conditions. Speed bumps slowing access to cancer medicines are likely to get higher, imperiling the health of patients, especially those who do not manage to overcome the obstacles.

An Aug. 13 report from IQVia Holdings Inc. (NYSE:IQV) catalogs the effects of formulary exclusions, financial considerations and dispensing site restrictions on patient access to both provider- and patient-administered oncology medications. It demonstrates the formidable influence payers have on patient access despite the bedrock promise of Medicare Part D that all plans cover all cancer drugs, along with those in the five other “protected classes.” This requirement does not apply to commercial plans. ...