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Yi-Ting
Chou
Author
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Spring 2018
2018
Health care management
Public health
Pharmaceutical sciences
accessibility, affordability, cancer care, cost-sharing, drug cost, non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
Yi-Ting
Chou
Author
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Spring 2018
2018
Health care management
Public health
Pharmaceutical sciences
accessibility, affordability, cancer care, cost-sharing, drug cost, non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
Yi-Ting
Chou
Author
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Spring 2018
2018
Health care management
Public health
Pharmaceutical sciences
accessibility, affordability, cancer care, cost-sharing, drug cost, non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
Yi-Ting
Chou
Author
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Spring 2018
2018
Health care management
Public health
Pharmaceutical sciences
accessibility, affordability, cancer care, cost-sharing, drug cost, non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
University of North Carolina at Chapel Hill
Degree granting institution
Yi-Ting
Chou
Creator
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Health care management
Public health
Pharmaceutical sciences
accessibility; affordability; cancer care; cost-sharing; drug cost; non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
University of North Carolina at Chapel Hill
Degree granting institution
2018
2018-05
Yi-Ting
Chou
Author
Pharmaceutical Sciences
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
Spring 2018
2018
Health care management
Public health
Pharmaceutical sciences
accessibility, affordability, cancer care, cost-sharing, drug cost, non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Pharmaceutical Sciences
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
Yi-Ting
Chou
Creator
Pharmaceutical Sciences Program
Accessibility and Affordability of High Priced Drugs in Advanced Non-Small Cell Lung Cancer
Lung cancer is the leading cause of cancer death in the U.S. It is a disease with poor prognosis that mainly occurring in older population. Treatment options have been increasing for lung cancer recently. However, high out-of-pocket costs is a major concern regarding the use of novel drug treatments, which could impact patient’s choice of treatment and even poorer patient outcomes in the long term. Among all, health insurance is an important modifier of financial burden. The study objectives were to examine the extent of Medicare’s benefit designs for drug treatments and the effect of cost-sharing support on treatment uptake in advanced non-small cell lung cancer (NSCLC).
We first used Medicare plan formulary files to evaluate the changes in drug prices and benefit designs for lung cancer medications. We then used the SEER-Medicare databases to examine drug utilization, key factors associate with the use through modified Poisson regression, and the effect of cost-sharing support through low-income subsidy on the timing of treatment initiation in the advanced NSCLC population through multivariable COX proportional hazards regression and propensity score weighting.
We observed higher entry prices at FDA approval overtime in Part D advanced NSCLC drugs while considerable price hike was also found in older drugs. In addition, high adoption rates of specialty/top tier and utilization management tools were found among Part D plans and across treatment options. The use of Part D medications has been stable but lower than expected.
Particularly, we found that low-income subsidy served as a critical factor for Part D drug use and timely initiation of Part D treatment among the advanced NSCLC population.
With current plan benefits and ever-increasing drug prices, concerns over affordability of and accessibility to Part D treatments could continue for advanced NSCLC patients. Patient out-of-pocket costs could particularly present a considerable barrier to timely treatment initiation. In the context of current evolving health care reform, identifying sustainable strategies to improve patient affordability of and equal access to high quality care are needed for the cancer population.
2018-05
2018
Health care management
Public health
Pharmaceutical sciences
accessibility; affordability; cancer care; cost-sharing; drug cost; non-small cell lung cancer
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Stacie
Dusetzina
Thesis advisor
Jennifer
Elston Lafata
Thesis advisor
Joel
Farley
Thesis advisor
Thomas
Stinchcombe
Thesis advisor
Amber
Proctor
Thesis advisor
text
Chou_unc_0153D_17613.pdf
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affiliation|Pharmaceutical Sciences Program