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  11. Cost Sharing For Oral Lenvatinib Among Commercially Insured Patients

Cost sharing for oral lenvatinib among commercially insured patients

Margaret I Liang1, Ling Chen, Emeline M Aviki

  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 W 3rd St, Ste 160W, Los Angeles, CA 90048.

The American Journal of Managed Care
|March 8, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Commercially insured cancer patients prescribed lenvatinib (Lenvima) had low out-of-pocket costs, with 75% paying $100 or less monthly. This study highlights the need for financial assistance programs to address high drug costs and potential patient barriers.

Area of Science:

  • Oncology
  • Health Economics
  • Pharmaceutical Policy

Background:

  • Lenvatinib (Lenvima) is a targeted therapy used to treat various cancers, including thyroid, renal cell, hepatocellular, and endometrial carcinoma.
  • Understanding cost-sharing trends is crucial for assessing patient access to essential cancer medications.
  • Previous research has not fully elucidated the cost-sharing landscape for lenvatinib among commercially insured populations.

Purpose of the Study:

  • To evaluate cost-sharing trends for lenvatinib (Lenvima) in commercially insured cancer patients.
  • To analyze trends in total, insurance liability, coordination of benefits, and out-of-pocket costs for lenvatinib prescriptions.
  • To identify potential financial barriers to lenvatinib access for patients.

Main Methods:

  • Utilized IBM MarketScan databases, including nationwide pharmaceutical claims from 2015-2019.

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  • Included patients with at least one outpatient pharmaceutical claim for lenvatinib on a noncapitated basis.
  • Estimated median and IQR costs for 30-day supplies, inflation-adjusted to 2019 US dollars.

    • Main Results:

    • A total of 685 patients with various cancers were included.
    • The median 30-day cost of lenvatinib was $17,253, with insurance covering the majority.
    • 75% of patients had out-of-pocket costs of $100 or less per month; however, some faced significantly higher costs (max $12,538).

    Conclusions:

    • Insurance effectively covered most lenvatinib costs, resulting in low out-of-pocket expenses for most patients.
    • Despite low median out-of-pocket costs, a subset of patients experienced substantial financial burdens.
    • Recommends enhanced financial assistance programs and policy reforms to mitigate high drug costs and ensure patient access to lenvatinib.