Characterizing Out-of-Pocket Payments and Financial Assistance for Patients Prescribed Abiraterone and Enzalutamide at an Academic Cancer Center Specialty Pharmacy

2021 ◽  
pp. OP.21.00168
Author(s):  
Angelina Y. Jeong ◽  
Eric B. Schwartz ◽  
Andrea R. Roman ◽  
Rachel L. McDevitt ◽  
Mary K. Oerline ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Insurance Coverage ◽  
Financial Assistance ◽  
Cancer Center ◽  
Assistance Program ◽  
Time To Initiation ◽  
Out Of Pocket Payments ◽  
Specialty Pharmacy ◽  
Final Cohort ◽  
Out Of Pocket Costs

PURPOSE Abiraterone and enzalutamide are commonly used oral cancer therapies for patients with prostate cancer, both with potentially high out-of-pocket costs for patients. We investigated the prevalence of financial assistance mechanisms used to alleviate out-of-pocket costs and the association of these mechanisms with timing of treatment initiation of abiraterone or enzalutamide. METHODS Using data from the medical center's specialty pharmacy, we identified first prescriptions for abiraterone or enzalutamide between January 1, 2017, and March 31, 2019. Prescriptions dispensed at an external pharmacy or that were discontinued for reasons unrelated to cost were excluded. Patient demographics, insurance coverage, out-of-pocket cost, and number of days between prescribed date and pill-to-mouth date were collected. RESULTS Among 220 prescriptions in our final cohort, 185 were filled through our internal specialty pharmacy, 23 through a manufacturer-sponsored patient assistance program (PAP), and 12 were never filled because of cost. One third of the prescriptions in our final cohort (n = 66) were filled with financial assistance: PAP (10%), copay cards (9%), and grants (11%). The median amount of assistance received for the first fill was $2,860 US dollars (USD) (interquartile range $1,856-$10,717 USD). Prescriptions with an out-of-pocket cost < $100 USD were filled in the shortest time (median 5 days), whereas those filled through a PAP had the longest time to initiation (median 30.5 days). CONCLUSION Among patients prescribed oral therapies for prostate cancer at a single institution, one third of patients received financial assistance. Although receiving assistance is likely to improve financial toxicity, waiting for assistance may lead to longer time to initiation of medication.

199: Correlates of Access to Prostate Cancer Care in a Statewide Public Assistance Program

2007 ◽  
Vol 177 (4S) ◽  
pp. 67-67
Author(s):  
David C. Miller ◽  
Laura Baybridge ◽  
Lorna C. Kwan ◽  
Ronald Andersen ◽  
Lillian Gelberg ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Care ◽  
Public Assistance ◽  
Assistance Program

966: Radical Prostatectomy for Lymph Node Positive Prostate Cancer: The M.D. Anderson Cancer Center Experience

2006 ◽  
Vol 175 (4S) ◽  
pp. 311-312
Author(s):  
Philippe E. Spiess ◽  
Joseph E. Busby ◽  
Jennifer Jordan ◽  
Mike Hernandez ◽  
Patricia Troncoso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Cancer Center ◽  
Node Positive ◽  
Lymph Node Positive

scholarly journals Adherence and out‐of‐pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer

Cancer ◽  
2020 ◽  
Vol 126 (23) ◽  
pp. 5050-5059
Author(s):  
Megan E. V. Caram ◽  
Mary K. Oerline ◽  
Stacie Dusetzina ◽  
Lindsey A. Herrel ◽  
Parth K. Modi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Targeted Therapies ◽  
Advanced Prostate Cancer ◽  
Medicare Beneficiaries ◽  
Out Of Pocket Costs

scholarly journals Differential Expression of a Panel of Ten CNTN1-Associated Genes during Prostate Cancer Progression and the Predictive Properties of the Panel towards Prostate Cancer Relapse

Genes ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 257
Author(s):  
Yan Gu ◽  
Mathilda Jing Chow ◽  
Anil Kapoor ◽  
Xiaozeng Lin ◽  
Wenjuan Mei ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Differential Expression ◽  
Cancer Progression ◽  
Lncap Cell ◽  
Endocrine Resistance ◽  
Gene Panel ◽  
The Cancer Genome Atlas ◽  
Cancer Center ◽  
Poor Overall Survival ◽  
Cell Renal Cell Carcinoma

Contactin 1 (CNTN1) is a new oncogenic protein of prostate cancer (PC); its impact on PC remains incompletely understood. We observed CNTN1 upregulation in LNCaP cell-derived castration-resistant PCs (CRPC) and CNTN1-mediated enhancement of LNCaP cell proliferation. CNTN1 overexpression in LNCaP cells resulted in enrichment of the CREIGHTON_ENDOCRINE_THERAPY_RESISTANCE_3 gene set that facilitates endocrine resistance in breast cancer. The leading-edge (LE) genes (n = 10) of this enrichment consist of four genes with limited knowledge on PC and six genes novel to PC. These LE genes display differential expression during PC initiation, metastatic progression, and CRPC development, and they predict PC relapse following curative therapies at hazard ratio (HR) 2.72, 95% confidence interval (CI) 1.96–3.77, and p = 1.77 × 10−9 in The Cancer Genome Atlas (TCGA) PanCancer cohort (n = 492) and HR 2.72, 95% CI 1.84–4.01, and p = 4.99 × 10−7 in Memorial Sloan Kettering Cancer Center (MSKCC) cohort (n = 140). The LE gene panel classifies high-, moderate-, and low-risk of PC relapse in both cohorts. Additionally, the gene panel robustly predicts poor overall survival in clear cell renal cell carcinoma (ccRCC, p = 1.13 × 10−11), consistent with ccRCC and PC both being urogenital cancers. Collectively, we report multiple CNTN1-related genes relevant to PC and their biomarker values in predicting PC relapse.

scholarly journals Head-to-Head Comparison of Two Nomograms Predicting Probability of Lymph Node Invasion in Prostate Cancer and the Therapeutic Impact of Higher Nomogram Threshold

2021 ◽  
Vol 10 (5) ◽  
pp. 999
Author(s):  
Zilvinas Venclovas ◽  
Tim Muilwijk ◽  
Aivaras J. Matjosaitis ◽  
Mindaugas Jievaltas ◽  
Steven Joniau ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Area Under The Curve ◽  
Pelvic Lymph Node ◽  
Cancer Center ◽  
Study Cohort ◽  
Net Benefit ◽  
Characteristic Analysis ◽  
Therapeutic Impact ◽  
Mskcc Nomogram

Introduction: The aim of the study was to compare the performance of the 2012 Briganti and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms as a predictor for pelvic lymph node invasion (LNI) in men who underwent radical prostatectomy (RP) with pelvic lymph node dissection (PLND), to examine their performance and to analyse the therapeutic impact of using 7% nomogram cut-off. Materials and Methods: The study cohort consisted of 807 men with clinically localised prostate cancer (PCa) who underwent open RP with PLND between 2001 and 2019. The area under the curve (AUC) of the receiver operator characteristic analysis was used to quantify the accuracy of the 2012 Briganti and MSKCC nomograms to predict LNI. Calibration plots were used to visualise over or underestimation by the models and a decision curve analysis (DCA) was performed to evaluate the net benefit associated with the used nomograms. Results: A total of 97 of 807 patients had LNI (12%). The AUC of 2012 Briganti and MSKCC nomogram was 80.6 and 79.2, respectively. For the Briganti nomogram using the cut-off value of 7% would lead to reduce PLND in 47% (379/807), while missing 3.96% (15/379) cases with LNI. For the MSKCC nomogram using the cut-off value of 7% a PLND would be omitted in 44.5% (359/807), while missing 3.62% (13/359) of cases with LNI. Conclusions: Both analysed nomograms demonstrated high accuracy for prediction of LNI. Using a 7% nomogram cut-off would allow the avoidance up to 47% of PLNDs, while missing less than 4% of patients with LNI.

scholarly journals Out-of-Pocket Costs and Perceived Financial Burden Associated with Prostate Cancer Treatment in a Quebec Remote Area: A Cross-Sectional Study

2020 ◽  
Vol 28 (1) ◽  
pp. 26-39
Author(s):  
Abir El-Haouly ◽  
Anais Lacasse ◽  
Hares El-Rami ◽  
Frederic Liandier ◽  
Alice Dragomir
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
University Education ◽  
School Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Perceived Burden ◽  
Out Of Pocket Costs

Background: In publicly funded healthcare systems, patients do not pay for medical visits but can experience costs stemming from travel or over-the-counter drugs. We lack information about the extent of this burden in Canadian remote regions. This study aimed to: (1) describe prostate cancer-related out-of-pocket costs and perceived financial burden, and (2) identify factors associated with such a perceived burden among prostate cancer patients living in a remote region of the province of Quebec (Canada). Methods: A cross-sectional study was conducted among 171 prostate cancer patients who consulted at the outpatient clinic of the Centre Hospitalier de Rouyn-Noranda. Results: The majority of patients (83%) had incurred out-of-pocket costs for their cancer care. The mean total cost incurred in the last three months was $517 and 22.3% reported a moderate, considerable or unsustainable burden. Multivariable analysis revealed that having incurred higher cancer-related out-of-pocket costs (OR: 1.001; 95%CI: 1.001–1.002) private drug insurance (vs. public, OR: 5.23; 95%CI: 1.13–24.17) was associated with a greater perceived financial burden. Having better physical health-related quality of life (OR: 0.95; 95%CI: 0.913–0.997), a university education (vs. elementary/high school level, OR: 0.03; 95%CI: 0.00–0.79), and an income between $40,000 and $79,999 (vs. ≤ $39,999, OR: 0.15; 95%CI: 0.03–0.69) were associated with a lower perceived burden. Conclusion: Prostate cancer patients incur out-of-pocket costs even if they were diagnosed many years ago and the perceived burden is significant. Greater attention should be paid to the development of services to help patients manage this burden.

Immigration Relief and Insurance Coverage: Evidence from Deferred Action for Childhood Arrivals

2020 ◽  
Vol 20 (3) ◽  
Author(s):  
Jung Bae
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Financial Assistance ◽  
Eligibility Criteria ◽  
Deferred Action ◽  
Percentage Points ◽  
Health Institutions ◽  
Medical Financial Assistance ◽  
The U.S

AbstractI find that the 2012 Deferred Action for Childhood Arrivals (DACA) program, which conferred protection from deportation and work authorization to undocumented immigrants who had been brought to the U.S. as children, increased eligible immigrants’ likelihood of having health insurance coverage. Exploiting a cutoff rule in the eligibility criteria of DACA, I implement a difference-in-regression-discontinuities design. The insured rate increased by up to 4.3 percentage points more for DACA-eligible immigrants than for ineligible immigrants following DACA. Two-thirds of this increase is accounted for by upticks in employer-sponsored and privately purchased insurance. The findings are also consistent with immigrants becoming less averse to approach health institutions, and taking up medical financial assistance at a higher rate.

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