What Caught Our Eye: Medicaid Coverage Limits; Cancer Care Cost Communication; Stanford Care Planning Study; Drug Pricing; and More

“After Approving Medicaid Work Requirements, Trump HHS Aims for Lifetime Coverage Limits”

.@HHSgov considering lifetime limits on #Medicaid coverage is very concerning. Would be devastating for #Cancer patients as many would be among first to hit limits due to high cost of cancer care, including those patients depending on Medicaid for their long-term follow-up care. https://t.co/DA6hBZ6pDs

— NCCS – National Coalition for Cancer Survivorship (@CancerAdvocacy) February 6, 2018

BREAKING: This would be the wrong direction for our country and millions of Americans.

https://t.co/jqeS9JNpUW

— Andy Slavitt @ 🏡 (@ASlavitt) February 6, 2018

By Tony Pugh, McClatchy News — After allowing states to impose work requirements for Medicaid enrollees, the trump administration is now pondering lifetime limits on adults’ access to coverage.

Capping health care benefits — like federal welfare benefits — would be a first for Medicaid, the joint state-and-federal health plan for low-income and disabled Americans.
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“Despite Changes That Undermined ACA Enrollment, Marketplaces ‘Remarkably Stable’”

Marketplace directors release report showing a mixed bag on ACA enrollment — and warn of sharp price hikes for 2019 if nothing is done. https://t.co/nYfplpxaZ9

— Julie Appleby (@Julie_appleby) February 8, 2018

By Julie Appleby, Kaiser Health News — After much drama leading to this year’s open enrollment for Affordable Care Act coverage — a shorter time frame, a sharply reduced federal budget for marketing and assistance, and confusion resulting from months of repeal-and-replace debate — the final tally paints a mixed picture.
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“Bipartisan Senate Budget Deal Boosts Health Programs”

next #WTHealth podcast coming tomorrow (waiting for outcome of budget fight). But meanwhile here's my and @shefalil's take on health items in the deal: https://t.co/jxqvIJ7f5G

— julie rovner (@jrovner) February 8, 2018

By Julie Rovner, NPR — In a rare show of bipartisanship for the mostly polarized 115th Congress, Republican and Democratic Senate leaders announced a two-year budget deal that would increase federal spending for defense as well as key domestic priorities, including many health programs.
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“Talking to Doctors about your Bucket List Could Help Advance Care Planning”

VJ Periyakoil (@palliator), lead author of a new study that found 91% of 3,056 U.S. participants surveyed had made a bucket list, discusses how bucket lists can aid talks about life goals, health and advance care planning: https://t.co/vFdktPV4DZ pic.twitter.com/PgySgT4FgE

— Stanford Medicine (@StanfordMed) February 8, 2018

Stanford Medicine News — A Stanford study has found that a majority of people make bucket lists and suggests they can be useful in doctor-patient discussions about care plans.
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“Price Transparency for Whom? In Search of Out-of-Pocket Cost Estimates to Facilitate Cost Communication in Cancer Care”

Price Transparency for Whom? In search of out-of-pocket cost estimates to facilitate cost communication in cancer care

Our editorial with Tina Shih and @sfuldnasso #financialtoxicityhttps://t.co/BWLTzbfVaK@DukeCancer @MDAndersonNews @dukemargolis @CancerAdvocacy

— Yousuf Zafar, MD MHS (@yzafar) February 6, 2018

By Ya-Chen Tina Shih, Shelley Fuld Nasso, and S. Yousuf Zafar, PharmacoEconomics — High costs of cancer drugs have repeatedly provoked a public outcry over affordability of cancer care in news media and journal articles. Especially for patients diagnosed with cancer in the United States, the sustained increase in the cost of cancer care is believe to cause tremendous distress for patients and their families to the extent that the term ‘financial toxicity’ has been used to describe patients’ cost-related experiences, and coping strategies are being discussed.
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“Association of Patient Out-of-Pocket Costs with Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents”

Important study in @JCO_ASCO: The more #cancer patients pay for oral chemo, the more likely they are to stop taking those drugs. Why?:

1) high drug prices
2) more cost-sharing
3) clinicians not talking costs w/ptshttps://t.co/Z8IEONqZpm #financialtoxicity @CostsofCare pic.twitter.com/1K9JDLdL3z

— Yousuf Zafar, MD MHS (@yzafar) February 8, 2018

ASCO’s Journal of Clinical Oncology — The number of novel oral anticancer agents is increasing, but financial barriers may limit access. We examined associations between out-of-pocket (OOP) costs and reduced and/or delayed treatment initiation.
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“Is Federal Policy Really To Blame For The High Cost of Cancer Care?”

Research on hospital mergers & cancer drug pricing shows how “difference-in-difference” analyses can help sort out "cause-and-effect." The finding serves as a reminder to be careful about leaping from a time trend to a cause-and-effect explanation. https://t.co/18EwG9kVYe pic.twitter.com/bwBJ4hHm96

— Peter Ubel (@peterubel) February 8, 2018

By Peter Ubel, Forbes.com — U.S. healthcare costs have been high for decades, outpacing other developed countries since at least the 1980s. But costs continue to rise, and that is causing many experts to ask why. Some people blame federal policies. As an example, they point to reimbursement policies that create incentives for healthcare providers to consolidate. When hospitals merge with each other, or when hospitals buy out physician practices, healthcare providers gain negotiating leverage over insurers, which enables them to negotiate higher prices.
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“Drugs Don’t Work If People Can’t Afford Them: The High Price of Tisagenlecleucel”

Drugs don’t work if people can’t afford them. Americans deserve transparency in pricing decisions for durigs invented using taxpayer funding. @P4AD_ @PORTAL_Research https://t.co/m9vgX12tTF

— Health Affairs (@Health_Affairs) February 8, 2018

Via Health Affairs Blog — In a system in which life-saving drugs are developed with direct and indirect taxpayer support and afforded market protection through government-granted exclusivities, patients deserve to know how drug manufacturers are arriving at ever-higher prices for their products. Without such information—and subsequent policy reforms based on it—treatment will become increasingly unaffordable. Sadly, for many Americans, it already has; 21 percent of 1,204 respondents in a December 2016 Henry J. Kaiser Family Foundation survey reported that they or a family member did not fill a prescription in the past year because of cost.
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