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Total and Out-of-Pocket Costs of PARP Inhibitor Therapy for Ovarian Cancer

January 22, 2021

PARP inhibitor therapy costs account for over 90% of patients’ total out-of-pocket drug spending. However, payers are responsible for the majority of total PARP inhibitor costs among insured patients with ovarian cancer (Gynecol Oncol. 2020;S0090-8258[20]34218-9. doi:10.1016/j.ygyno.2020.12.015).

This study aimed to assess the total out-of-pocket costs for PARP inhibitors for ovarian cancer and identify cost differences based on insurance characteristics.

Patients with ovarian cancer who were prescribed niraparib, olaparib, or rucaparib identified using the MarketScan and Surveillance, Epidemiology, and End Results (SEER)-Medicare databases. Drug costs were estimated for a 30-day supply.

A total of 590 commercially insured patients with ovarian cancer prescribed PARP inhibitors for a median of 119 days were identified.  For commercially insured patients, the median total cost of PARP inhibitor therapy was $13,342. Median out-of-pocket cost was $44 and PARP inhibitors accounted for a median 90.8% of patients' total out-of-pocket drug spending.

A high-deductible health plan was not associated with higher out-of-pocket costs (n = 570; median $0 vs $45, P = .87).

For Medicare beneficiaries, the median total of PARP inhibitor therapy was $12,798. Median out-of-pocket cost was $370 and PARP inhibitors accounted for a median of 99%o of patients’ total out-of-pocket drug spending.

Out-of-pocket costs were lower for dual-eligible patients with supplemental Medicaid prescription drug coverage (n = 2019; median $1 vs $911, P <.001).

“Although insurers are responsible for a large proportion of PARP inhibitor costs, out-of-pocket costs for PARP inhibitors account for a majority of patients' drug spending,” concluded Margaret I Liang, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, and colleagues.

“SEER-Medicare beneficiaries had higher out-of-pocket costs than patients with commercial insurance, which was offset for those with supplemental Medicaid prescription coverage,” they added.—Janelle Bradley

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