PAN’s healthcare wishlist for 2020

As another year comes to a close, here at PAN we are taking a moment to give thanks for the many patients and families we have been able to help in 2019.

I also find myself looking ahead with cautious optimism to policy changes and further advancements in medical research that can do even more to help the underinsured afford their treatments, live longer and feel better. Specifically, here is what we hope to see in 2020:

A cap on out-of-pocket costs for Medicare Part D beneficiaries

Did you know that Medicare beneficiaries are the only group of insured people in the U.S. that are not protected by a cap on annual out-of-pocket costs? Some beneficiaries who require expensive medications can incur thousands of dollars out-of-pocket for their prescriptions in January alone. Instituting an out-of-pocket cap on drug costs would help patients better anticipate and plan for their medication expenses throughout the year. An annual cap would protect millions of low-income seniors, helping them avoid having to make difficult trade-offs or forgoing treatment altogether.

A way to spread out-of-pocket costs more evenly throughout the year

Medicare Part D prescription drug plans front-load out-of-pocket costs early in the benefit year, which can be devastating for patients who face high cost sharing for their medications. One study among Medicare beneficiaries living with rheumatoid arthritis, multiple sclerosis and chronic myelogenous leukemia found that more than half of all out-of-pocket medication costs were incurred in the first three months of the year. For many individuals and families, paying thousands of dollars at the beginning of the year is an enormous hardship. I hope that legislation will also limit what seniors pay out-of-pocket for their prescription medications on a monthly basis.

Expanded access to the Medicare Part D Low-Income Subsidy (LIS) program

The Medicare Part D LIS program, or Extra Help, was established to help low-income seniors and people with disabilities afford needed medicines. But not all eligible beneficiaries have enrolled—complex application processes and outdated eligibility thresholds have limited participation. The LIS program should be modernized to include a larger population of beneficiaries in need, eliminate cost sharing for generics and ensure all eligible beneficiaries are enrolled and taking advantage of the program.

New treatments for people with life-threatening, chronic and rare diseases

We have seen substantial progress in the development of new and life-saving therapies over the past decade, and we hope this momentum continues. Fortunately, many serious illnesses can now be managed as chronic conditions, prolonging life and giving individuals more time with their loved ones. PAN is proud to help patients afford these life-saving therapies. We hope the pace of research and development continues, so more people can get the treatment they need.

Learn more about what PAN hopes to see in 2020 and beyond.