Dr Thomas Graf Discusses the Effect of Novel Therapies on Private Coverage

Thomas Graf, MD, chief medical officer and vice president, Horizon Blue Cross Blue Shield of New Jersey, discusses the impact of new therapies on private insurance coverage for cancer patients.

Transcript

Will novel therapies have an effect on private coverage?

It’s going to drive cost in a way that’s not been seen. I mean, we’ve seen some explosion in pharmacy costs now exceeding often the physician costs for health insurers. That’s gonna leap another factor here, is that the drug costs continue to escalate as new therapies continue to be produced for more and more patients. The potential number of patients that are eligible for some of the drugs that are available is quite small. The newer drugs will have much wider approachable patient panels. So, the ability to impact total cost for insurers, for employers, for the federal government is dramatic. So, I think some employers will thereby not be able to offer coverage because it will become so expensive to their employees which will drive them to different markets. Clearly, there’s a reduction in the insurance mandate. So, I suspect a lot of patients will go from having private coverage to not having private coverage and then we’re going to have a real issue because access to those drugs will be very restricted in that group.