This supplement showcases the winning papers and case studies from the PAN Challenge, which aimed to stimulate a dialogue on ways to reduce or eliminate the barriers and disparities that Medicare and ACA enrollees face in obtaining medications to treat life-threatening, chronic, and rare diseases.
Am J Manag Care. 2017;23(3 Suppl):S38Today’s health insurance system is far from perfect. Although Medicaid, Medicare, state exchanges, and employer-based health plans generally meet most individuals’ needs, unfortunately, approximately 31 million Americans find themselves underinsured.1 Many of these individuals live with life-threatening, chronic, and rare diseases, and struggle with access and affordability issues because of limited networks, restricted formularies, and high out-of-pocket costs.
For those who are underinsured, independent charitable foundations, such as the Patient Access Network (PAN) Foundation, provide an important safety net by paying for a portion of their out-of-pocket costs. The need for such assistance has significantly grown over the past few years. In fact, over the past 2 years, with the generous support of our donors, the PAN Foundation has provided over $1.7 billion in charitable assistance to nearly half-a-million seriously ill patients.
Much of the assistance provided by the PAN Foundation has benefited Medicare beneficiaries. Today, approximately 16 million, or 40%, of Medicare Part D beneficiaries fall between 150% and 400% of federal poverty level, so their incomes are too high to qualify for the Low-Income Subsidy, and many cannot afford their critical medications without some form of assistance. The need for the safety net will continue to grow given the increasing number of Medicare beneficiaries; the likelihood of cutbacks in health insurance coverage under the Affordable Care Act (ACA), which affect individuals of all ages; possible cutbacks in Medicare and Medicaid; and the upward trend in the cost of treatment.
With the concern for the safety net as a backdrop, the PAN Foundation is pleased to have continued our partnership with The American Journal of Managed Care® (AJMC®) for the second year in a row, and to have together sponsored the 2017 PAN Challenge. The PAN Challenge included a call for papers (summer 2016) titled, “Beyond Charitable Assistance: Sustainable Strategies for Providing Access to Critical Medications.” The national competition solicited papers that propose ways to reduce or eliminate barriers and disparities that Medicare and ACA enrollees face in obtaining medications to treat life-threatening, chronic, and rare diseases. The 2 winning papers of the PAN Challenge are featured in this supplement and we are also happy to include 2 case studies on the topic of innovative programs to mitigate financial toxicity for patients. We hope that these papers and case studies will continue to stimulate a dialog about how to ease the financial burden and improve the quality of life for millions of patients and their families.REFERENCE
1. Collins SR, Rasmussen PW, Beutel S, Doty MM. The problem of underinsurance and how rising deductibles will make it worse—findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. Commonwealth Fund website. http://www.commonwealthfund. org/publications/issue-briefs/2015/may/problemof-underinsurance. Published May 20, 2015. Accessed February 2017.