Segment 9 - The Role of Insurance and Medicare

Dr Chernew asks panelists about the role of insurers and Medicare for patients in the treatment of multiple myeloma. While insurers may not have necessarily been a barrier to care, costs of drugs have been.

Dr Reeder says that the insurance market shares the same concerns of the provider community, especially with regards to balancing the clinical and fiscal implications of patients’ treatment. The payer community is trying to better understand the evidence behind treatment options, and which patients would benefit most from certain treatments. He suggests that this kind of determination might be possible by knowing specific biomarkers. Insurers are seeking to see the link between effectiveness and cost.

Ms Young says that studies such as the CoMMpass study can assist insurers and providers alike in identifying which patients would benefit most from specific expensive agents.