IHPI, Rogel Cancer Center fund policy-relevant projects to inform and improve cancer care

The University of Michigan Institute for Healthcare Policy and Innovation (IHPI), in partnership with the U-M Rogel Cancer Center, announced two awardees for its 2023 Policy Sprint initiative. The IHPI/Rogel Cancer Center-led teams, chosen from many excellent proposals, will receive support for timely, policy-relevant projects that aim to inform and improve cancer care.

The selected teams will lead research projects that offer evidence-based considerations to inform ongoing decision-making at local, state, and national levels. Both projects will study aspects of the financial toxicity of cancer treatment related to cancer drug prices, coverage by federal programs, patient out-of-pocket costs, and access to care among low-income patients. 

Thanks to generous support from IHPI donors and the Rogel Cancer Center, each of the teams will receive $10,000 in funding, as well as guidance from the IHPI policy engagement and communications staff. Paula Lantz, Ph.D., M.S., M.A., professor of public policy, will also advise the project teams in her role as faculty advisor for IHPI Policy Engagement and External Relations.

Projects will begin immediately and conclude within the next three to six months. At the conclusion of their project, each team will produce a policy-relevant deliverable, such as an IHPI policy brief, video, one-pager, or infographic, to summarize research findings and key policy considerations. They will then work with the IHPI policy engagement team to share their work with policymakers and other key stakeholders.

The awarded Policy Sprint projects and research teams are:

Effect of the 340B drug pricing program on advanced prostate cancer care
Project leads: Kassem Faraj, M.D., IHPI Scholar, Urology, Medical School, Vahakn Shahinian, M.D., M.S., Internal Medicine, Medical School, Lindsey Herrel, M.D., M.S., Urology, Medical School

In recent years, treatment for advanced prostate cancer has expanded to include oral targeted therapies that target specific cancer cells affecting tumor growth and have been shown to improve patient survival and quality of life. While preferred by patients over chemotherapy, these newer therapies are substantially more expensive, leading to significant out-of-pocket costs, particularly for low-income and uninsured patients. The federal 340B drug pricing program, which requires that pharmaceutical manufacturers sell medications at a steep discount to hospitals serving a high proportion of socioeconomically disadvantaged patients, may help more patients access oral targeted therapies but its impact is currently understudied.

In this Policy Sprint, the research team will assess the 340B program’s potential effect on patient-level access and quality of care, as well as explore policy considerations to further improve patient access to this important class of medications. They will do this by examining the relationship between 340B hospital participation and the use of oral targeted therapies, patient out-of-pocket spending, and medication adherence among socioeconomically disadvantaged patients with advanced prostate cancer. 

Evaluating out-of-pocket cost variability of cancer medications insured by Medicare Part D plans
Project lead: Kristian Stensland, M.D., M.P.H., M.S., Urology, Medical School 
Team members: Ben Pockros, M.D., M.B.A., Urology, Medical School, Chad Ellimoottil, M.D., M.S., Urology, Medical School, Megan Caram, M.D., Internal Medicine, Medical School

Medications for various types of cancer have been shown to cost more than $10,000 in annual out-of-pocket costs for Medicare beneficiaries. Medicare Part D, a prescription drug benefit, offers the average beneficiary a choice of more than 50 different drug plans, some of which provide more coverage for cancer medications than others. However, fewer than 30% of patients report comparing drug plan pricing prior to selecting a plan, leading many Medicare beneficiaries with cancer to select plans that result in high out-of-pocket costs. 

An initial analysis by the U-M researchers found that out-of-pocket costs for prostate cancer medications significantly vary by Part D plan and that strategic plan selection could save patients up to $9,000 per year. In this Policy Sprint, the research team will expand their analysis of Part D plans by examining out-of-pocket cost variability of common medications for patients with breast cancer, multiple myeloma, leukemia, and lymphoma. They will then create educational materials about Part D cost-sharing requirements to help optimize plan selection and reduce out-of-pocket drug costs for patients.