There are many health policy proposals circulating Washington today that could impact people living with cancer. To better understand how health policy experts view these potential policy changes, we partnered with Morning Consult to survey more than 600 health policymakers and experts on key issues such as value-based arrangements (VBAs), utilization management (UM), international reference pricing (IRP) and Medicare Part B.
Using these data, we hope to start a conversation on how proposed policy changes should account for the complexities of cancer care — and not negatively impact people living with cancer.
Here is what we found:
Health policy experts are concerned about the impact of current health policies on people living with cancer.
- 55% believe that the current health policy landscape negatively impacts people living with cancer.
Respondents felt that current policies do not ensure equal access to safe and affordable treatments,
do not allow for enough funding in cancer research, favor discriminatory insurance benefit designs and, ultimately,
delay access to essential treatment.
Cancer treatment has made tremendous improvements in recent years and continues to evolve. As policymakers shape new health policies, it’s critical that they listen to patients and the physicians who treat them. These are the people on the frontlines of care who will feel the impact of those policies.
Ensuring Appropriate Coverage
High deductible health care plans put patients on the hook for additional out-of-pocket costs.
- They’re also becoming more widespread, which may explain why 43% of health policy experts chose “ensuring
appropriate health coverage” as the number one issue to address in health care.
- 82% of respondents also said they believe it’s important to maintain market-based reimbursement for Medicare Part B.
Health policy experts also recognize that UM is not appropriate for people living with cancer.
- 87% believe that UM practices by insurers, such as step therapy, delay access to essential treatment for people with cancer. Not only that — UM requirements can also increase patient stress and frustration, contribute to worse outcomes and cost patients more out of pocket.
Lowering the Cost of Medicines
Respondents were split about how to lower these costs.
- 46% believe drug prices should be determined using prices paid by other countries, while 42% believe drug prices should be determined using domestic market dynamics.
IRP is a practice used to benchmark drug prices by comparing domestic costs with the prices paid by another country or group of countries. Countries who implement IRP policies invest less in cancer research, ultimately leading to lower survival rates. Research suggests countries who invest more in cancer have better outcomes. In fact, the five-year survival rate for all cancers is 42% higher for men and 15% higher for women in the United States than in Europe.
U.S. progress in treating cancer is leading to longer lives and better quality of life, and the number of cancer survivors is steadily rising. We believe that reference pricing reform would put those advances at risk.
Linking the Value of Medicines to Outcomes
As our health care system is shifting from volume-based to value-based, VBAs enable new ways for biopharmaceutical companies to stand behind the value of their medicines. Unlike the traditional fee-for-, which bases payment strictly on the number of products sold, VBAs link reimbursement to specific health outcomes.
Respondents were aligned that VBAs are beneficial to people living with cancer.
- 84% of respondents said they believe VBAs are important in reducing the overall system-wide costs associated with providing cancer care.
VBAs for medicines are still relatively new, but in order to better facilitate these arrangements, we need to update and improve outdated laws and regulations. Lilly is dedicated to helping address these barriers and champion more VBAs.
At Lilly, our mission is to make medicines that help people live longer, healthier, more active lives.
We believe the entire health care community — payers, policymakers and pharmaceutical companies — must come together to create a better, more affordable system for patients.
We are committed to understanding the needs of people living with cancer and will continue advocating to ensure they are considered as health policy change is proposed.