The 7Th Annual Worldview Scorecard
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THE POWER OF COMMUNICATION DNA AS ANTI-AGING SOFTWARE BEATING BLOOD CANCER THE 7TH ANNUAL WORLDVIEW SCORECARD PARTNER PROFILE RIGHT PATIENT, RIGHT MEDICINE, RIGHT NOW Addressing the Barriers to Patient Access By JONATHAN WILCOX / Policy Director, Vital Options International By STACEY L. WORTHY, Esq. / Director of Public Policy, The Alliance for the Adoption of Innovations In Medicine t may seem obvious to proclaim that the cancer patient journey is one of crossroads moments and good news/bad news scenarios. But per- he definition of their insurance companies finally don’t have to travel to the doctor’s haps now more than ever, the oncology world is stirred by astonishing “conundrum” is agree to pay for the drug prescribed office every week, resulting in time Ibreakthroughs in lifesaving medicines simultaneous with ever-higher “a confusing and by their doctors. away from work or family. Yet, be- and more complex barriers to access for patients who need them. difficult problem One disturbing and wasteful insur- cause the co-pays can be hundreds When it comes to the science of cancer, these are definitely the best or question,”—a ance practice is what is euphemisti- or thousands of dollars per month, of times. Exciting discoveries occurring in every area of cancer research definition that clearly cally called “step therapy” or “fail studies find almost 10 percent of are producing treatments targeted to the unique molecular and genetic Tapplies to the growing number of first.” In this practice, although a insured patients choose not to fill characteristics of each person’s cancer. Add the excitement over new cancer patients who are prescribed doctor may prescribe a medication their initial prescriptions for oral immunotherapies that train a patient’s immune system to destroy cancer state-of-the art cancer medicines most suitable to the patient’s indi- anti-cancer medications. and it is clear that the transformative change of precision medicine is well and yet, delay taking them or don’t vidual needs, the insurance company To save lives, the patient com- underway. take them at all. usurps the doctor’s prescribing munity, cancer advocacy groups, For some cancer patients seeking to utilize these life-saving thera- According to the latest projec- authority by requiring the patient to and public health organizations are CONTACT YOUR ELECTED pies, however, all the world’s medical innovation might as well never have tions, nearly half of Americans first fail on several inferior medica- pressing Congress and state legis- OFFICIAL to Support Patient occurred. Even as medical advances create new, potentially life-saving latures to cap co- Access to Medical Innovation medicines for patients – and more quickly than ever before – ready access pays on specialty to these life-enhancing therapies is not assured. medicines and American College of Rheumatology Why? The path is blocked in two critical ways. “We have a health insurance failure for innovative medicines. ensure equality of LEGISLATIVE ACTION CENTER: The first is governmental. What we call “new” cancer treatments are If you get cancer today, your copays can prevent you from access and insur- www.rheumatology.org/actioncenter often 8-10 years old by the time they reach patients. Why isn’t this a mat- ance coverage American Society of Hematology ter of months? The main reason is that FDA regulations were designed accessing the medicines you desperately need. That’s a failure for all anti-cancer ORAL CANCER DRUG PARITY: to evaluate the modernism of the VCR and 8-track tapes. Appropriate for of health insurance.” Tomas Philipson, Ph.D., Professor, University of Chicago regimens. To date, www.hematology.org/Advocacy/ their time, perhaps, but increasingly ill-equipped to co-exist with today’s 39 states and Campaigns/667.aspx speedy scientific advances. Washington D.C. Arthritis Foundation The second is access. Tens of thousands of cancer patients are custom- have enacted oral SPECIALTY TIERS/CAP THE COPAY: arily confronted with rising copays, restricted coverage and all too often, diagnosed with a chronic disease tions before it will pay for the drug chemotherapy access laws, while 15 www.arthritis.org/advocate/ insurance practices that deny access completely. This is the bitter reality take their medicine as directed that the doctor originally prescribed. states and the District of Columbia our-policy-priorities/pass-the-patients of today’s access fights – with patients and their doctors denied medica- only 50 percent to 60 percent of Equally onerous is placing new can- have either introduced or passed -access-to-treatments-act.php tions every day by a complex coverage and reimbursement insurance the time. The consequence of this cer medicines into the highest phar- bills to limit what patients pay for International Myeloma Foundation system that surely does not want to be seen as standing in the way of sick poor medication adherence is more macy (“specialty”) tier and forcing specialty medicines. ORAL ANTICANCER TREATMENT people and their disease-altering treatments. doctor visits, trips to the emergency patients to pay a large percentage of The Alliance for the Adoption of ACCESS LEGISLATION: In response, a patient revolution has ignited and touched down in 39 room, and hospitalizations, all of the drug’s price. According to a re- Innovations in Medicine supports www.cqrcengage.com/myeloma/access states and Washington, D.C. to address the problem of inequitable cover- which is estimated to cost the health cent Leukemia & Lymphoma Society these policies because adhering to Leukemia & Lymphoma Society age by requiring health plans to equalize the patients’ out-of-pocket costs care system between $100 billion report, even the new state exchange cancer medicines is a necessity. It is LEGISLATIVE ACTION CENTER: between oral and intravenous therapies. Further state-by-state reform and $300 billion annually. plans implemented under the Patient time to end the adherence conun- www.lls.org/advocate/legislative- efforts will surely follow. action-center However, for Americans fighting Protection and Affordable Care Act drum by reducing the cost-sharing As a nonprofit organization working to improve cancer care, Vital a deadly cancer, the consequences for previously uninsured patients use barriers for cancer patients, so they National Organization for Options International (VOI) believes patients should not be forced to battle can also be life-threatening and this cost containment strategy. This can fill their prescriptions and take Rare Diseases the system and their cancer at the same time. This is why VOI supports CURRENT INITIATIVES AND ISSUES thus, the conundrum: Why are can- means patients can pay up to 50 the medicines they desperately need. energetic and innovative movements underway to update the drug ap- UPDATES: cer patients skipping doses or tak- percent of the costs of new can- It’s the right thing to do for www.rarediseases.org/advocacy/ proval process using 21st century computing capabilities, genomic analysis ing less than the prescribed amount cer therapies, which leads to poor patients, the healthcare system and initiatives-updates and a new understanding of cancer on a molecular level. of their cancer medicines? The adherence. our economy. We also hope legislators and regulators will work with doctors, Patient Services, Inc. answer is simple: In the name of Then, there is the practice of LEGISLATION: patients, caregivers and payors to provide faster and easier access to the cost-containment, insurance com- shifting as much as 25 percent of the www.patientservicesinc.org/ latest medications – and do so in a way that prioritizes patient safety and panies increasingly restrict patients’ cost of oral anti-cancer medicines Advocacy/Legislation supports the integrity of new drug evaluations. access to breakthrough cancer to patients in high co-pays—even To almost countless patients, there is only one obvious move left: medicines through high copays and though these drugs are less invasive Towards a regulatory future that embraces access and accepts nothing less practices that require patients to fail than intravenous infusions, they than the right patient, the right medicine and right now. on medication after medication until carry fewer side effects, and patients COVER ILLUSTRATION by Nicholas Sutton Bell 4 LET’S GIVE ’EM SOMETHING TO TALK ABOUT… WORLDVIEW SCORECARD BY JEREMY ABBATE, MIKE MAY & YALI FRIEDMAN 36 THE 7TH ANNUAL GLOBAL BIOTECHNOLOGY SURVEY SCIENTIFIC AMERICAN WORLDVIEW IS 5 yourVIEWS: PUBLISHED BY SCIENTIFIC AMERICAN Letters, Opinions, Critiques CUSTOM MEDIA WITH PROJECT 66 PRODUCTS OF THEIR ENVIRONMENT MANAGEMENT BY BY YALI FRIEDMAN SPECIAL REPORT: THE WORLDVIEW 100 How R&D location impacts which drugs are produced. Publishing & Media Director | JEREMY ABBATE Editorial Director | MIKE MAY 68 JOELLE BOLT 8 THE WORLDVIEW 100 LAWS OF ATTRACTION Art Director | How a nation’s policies attract and discourage biopharma investment Head, Data Analytics, The visionaries who continue to reshape biotechnology YALI FRIEDMAN BY MEIR PEREZ PUGATCH, DAVID TORSTENSSON, RACHEL CHU, AMIR DAYAN & NOA WEINSTEIN Scientific American Custom Media | —and the world Copy Chief & Content Consultant | GEORGINA KEENAN BENCH TO BUSINESS WORLDVIEW EVENTS Digital Production | ZOYA LYSAK Research & Administrative | ALEXANDRA HARIRI 22 FROM EUREKA TO USEFUL 72 AN EVENING WITH TOP MEDICAL INNOVATORS BOARD OF ADVISERS Developing an idea into a productive tool demands Today’s visionaries battle cancer