1. Program Coordinator Medication Assistance Program Smilow Cancer Hospital at Yale New Haven Program Coordinator Medication Assistance Program Smilow Cancer Hospital at Yale New Haven

2.   Consists of 5 FTE’s  Has been established for five years  Was originally mirrored from the Ohio State James Cancer Center Program- Columbus, Ohio Yale MAP Program

3.   Recovered $2.3 Million in Hospital Replacement drugs.  Obtained $6.3 Million in free patient take home medications.  Obtained $650,000 in copay grants, used to pay toward clinic infused drugs and take home medication copays. FY 2014

4.   Responsibilities: Manufacturing safe drugs. Manufacturing drugs that show clinical effectiveness for indicated disease states.  Ethical Issues: Ability for all patients to have access to their drugs without limiting access. Establish supportive resources for their patients in an attempt to help increase adherence. Pharmaceutical Companies Responsibilities & Ethical Issues

5.   The cost to bring an oncology drug to market can be in excess of $1 Billion dollars.  The value of human life is difficult to justify in a dollar amount.  The Medicare Reform Act of 2003 forbade Medicare from negotiating drug prices. Cost Factors in Drug Pricing

6.   The average cancer drug price for approximately 1 year of therapy or a total treatment duration was less than $10,000 before 2000, and had increased to $30,000 to $50,000 by 2005. In 2012, 12 of the 13 new drugs approved cancer indications were priced above $100,000 per year of therapy. 1.  1. Light DW, Kantarjian (2013) Market spiral pricing of cancer drugs. Cancer 119:3900–3902. Facts

7.   The 2013 average out of pocket expense of a commercial plan patient for oncology medication 2. IV $5643 Oral $2838 This cost is in addition to the patients other expenses: Additional copays : prescriptions, physicians Loss of wages during treatment Travel cost to treatment: gas, parking, public transportation Daycare/Eldercare  2. Herper, M,Forbes (2015) Pharma & Healthcare. IMS Real-WorldData Average Patient Out of Pocket Cost for oncology drugs in their treatment

8.   Office of Inspector General's (OIG) mission is to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program beneficiaries.

9.   Why do some pharmaceutical companies seem to be patient friendly and others do not seem as patient focused?  Conformability level with their free or copay drug programs and perception to the OIG. Regulation in Pharma

10.   Ability to start a patient on therapy without delay Trial vouchers

11.   To receive the drug through the Free Supply Program, a patient must meet the following criteria:  Be a new patient;  Receive a prescription for the drug;  Have an on-label diagnosis;  Have health insurance coverage through a private insurer or Federal health care program; and  Have experienced a delay in a coverage determination of at least five days. Approved on 8/11/2015 HHS office of OIG states no sanction of anti-kickback in voucher use

12.   With non-insured patients Brand drugs can offer a free program that generic drugs might not have. This is helpful in high cost generics.  Example is Genentech's Xeloda vs. Teva Generic Brand vs. Generic

13.   PAF (Patient Advocate Foundation) now has instant approval for grants in the appropriate disease funds.  Ovarian Fund is now available through PAF- $7,500 per year. (This fund will have greater funding in 2016).  PAF has a new phone App.  Funds for treatment transportation are available Foundations-Updates

14.   Smilow Cancer Hospital at Yale-New Haven Hospital coordinated the first time ever multi -drug company symposium for innovated practices in Medication Assistance Programs.  Attendees at this meeting were decision makers for the Pharmaceutical Companies Medication Assistance Programs. Best Practices

15.   Amgen  AbbVie  AstraZeneca  BMS  Celgene  Genentech  Lilly  Novartis Companies That Attended

16.   One universal website and application process for oncology medications operated by a third party.  One universal copay card for all oncology drugs.  Elimination of income criteria for copay programs.  Increase in income criteria for other medication assistance programs. Topics of the Meeting

17.  Addition