ACCESS TO INNOVATION AND ECONOMIC BURDEN----A CASE OF NON-SMALL CELL LUNG CANCER IN A PATIENT ACCESS PROGRAM IN QINGDAO, CHINA
Author(s)
Chen W, Lin Y, Zhang L
Fudan University, Shanghai, China
Presentation Documents
OBJECTIVES: A patient access program (PAP) was adopted by local health insurance scheme in Qingdao since 2012 to provide the coverage of innovative products for catastrophic diseases including non-small cell lung cancer. This study aims to measure the impact of PAP on economic burden of the patients with non-small cell lung cancer. METHODS: The patients with non-small cell lung cancer during 2008 and 2013 were identified from health insurance information system. All claims data, including total treatment fees, the composition and the out-of-pocket fees born by the patients, were collected and a comparative analysis before and after the PAP implementation was conducted. RESULTS: The PAP was achieved through price negotiation between local health insurance agent and manufacturers and reimbursed 70% of the cost of PAP-covered innovative medicines including Icotinib for non-small cell lung cancer. Totally 299 new patients with non-small cell lung cancer registered in PAP and another 78 patients were identified to switch from routine chemotherapies into Icotinib regimen. Before PAP, the average monthly treatment fees under the routine continuous chemotherapies were RMB11,333 (USD1,828) per patient, with 34.8% (RMB3,939) born by the patient out-of-pocket. Under PAP, for the same patient group, the patients monthly self-paid RMB4,519 (USD729) of the average fees for Icotinib and another RMB1,064 (USD172, 16.9% of total fees) for other drugs and routine treatment. CONCLUSIONS: The PAP, which provides the targeted patients the access to innovative medicines with better efficacy and safety, greatly decreased the fees on routine treatment, but also brought additional self-paid cost on PAP-covered medicines. Further researches are needed to help decision makers to make the tradeoff among better accessibility, increasing cost and improved outcomes from the clinical utilization of PAP-covered innovative medicines.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PCN351
Topic
Health Policy & Regulatory
Topic Subcategory
Risk-sharing Approaches
Disease
Oncology