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Dear Liz,
As we approach the holiday season and end of the year, we’re happy to share with you some updates about what the PAN Foundation has been doing to support and advocate for patients across the country.
While our enhanced enrollment system is ready after additional testing, given how close we are to our busiest enrollment period for patients, we have decided to reschedule our launch for early 2024. Check out the update below to learn more about our launch plans.
As a follow up to our previous announcement, Avalere has updated their analysis about the 2025 Medicare Part D reforms to include beneficiaries who are expected to newly start treatment within the eight therapeutic areas analyzed. Most notably, Avalere estimates that anywhere from 6 to 86 percent more beneficiaries could be on therapy in these therapeutic areas as a result of the reforms. However, the updated analysis also points to the fact that many will still face affordability challenges. You can learn more about these updated findings below.
We also continue to hear directly from patients about the impact Medicare Part D reforms will have on them, and why they’ll still need to turn to PAN for financial assistance. As one PAN grant recipient, Don, said, “Like all cancer patients, we’re wrestling with the cost of the drugs that it takes to [fight] this disease. I’m thankful to PAN for helping me bridge the costs of my drugs. $2,000 for many is a matter of eating or not eating.” We will continue to be here to provide the support needed for patients like Don to start and stay on treatment.
And as we move into this season of Thanksgiving, we thank you once again for your generous support so we can connect patients with the medications and treatments they need and deserve.
Yours in health,
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Rescheduled launch of enhanced enrollment system
Although the PAN Foundation’s enhanced enrollment system is ready following additional testing, we have decided to reschedule the launch for early 2024 given how close we are to our busiest enrollment period for patients. This busy enrollment period—known internally as surge—is when patients’ deductibles and out-of-pocket maximums reset at the beginning of the plan year, resulting in a higher volume of applications to PAN for financial assistance.
By rescheduling the launch of our enrollment system, we aim to ensure readiness to serve patients and providers to the best of our ability and reduce the chances for any unforeseen impacts during a time when thousands of patients and their families are depending on the PAN Foundation. Once it’s launched in early 2024, our enhanced system will provide patients and providers with a high-quality, efficient, easy-to-use enrollment experience.
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Updated analysis from Avalere on Medicare Part D reforms
Following up on initial analysis released last month, Avalere released updated analysis—sponsored by the PAN Foundation—looking at the impact of the 2025 Medicare Part D reforms on both existing and new users within eight key therapeutic areas. The analysis points to a projected increase in new users starting therapy across six of the eight therapeutic areas analyzed, ranging from a 6 to 86 percent increase.
Once again, the updated analysis assumes conservative, or low level, estimates of beneficiary utilization and plan formulary management responses. Should plans implement higher response scenarios through formulary management, patients will be impacted more when it comes to access, affordability, and medication uptake and adherence.
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Released polling results on specialty medication coverage
A recent national poll from the PAN Foundation finds that many commercially insured patients taking specialty medications report facing medication access issues through their employer-sponsored health plans. Key findings include:
- 1 in 4 respondents (25 percent) covered by commercial insurance say their plan has told them that the specialty medication they need access to is a “non-essential health benefit.”
- 1 in 3 respondents (29 percent) covered by commercial insurance say they have been referred to an external company by their plan to help them find financial assistance for their specialty medication.
- 1 in 3 respondents (28 percent) covered by commercial insurance have been told the financial aid they receive for their specialty medication will not count toward their deductible or out-of-pocket maximum.
While the poll did not specifically ask about copay accumulators, maximizers, or alternative funding programs, these findings suggest that many employer-sponsored health plans may be using these policies, which harm patients.
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Providing educational webinar on 2024 Medicare Part D reforms
To help patients and healthcare professionals better understand the 2024 changes to the Medicare Part D program, the PAN Foundation will host a free webinar on November 29 at 1:00 pm ET. The webinar will feature PAN’s Chief Advocacy Engagement Officer, Amy Niles, and Senior Manager of Clinical Affairs, James Ridley, who will cover:
- What Medicare Part D changes will begin in 2024
- How these changes may potentially reduce out-of-pocket costs
- How PAN will continue to support patients in 2024
As a reminder, we are preparing to implement some disease fund assistance amount changes starting January 1, 2024. These changes are part of our yearly review to ensure alignment with PAN’s demand models and incorporate consideration of the new Medicare Part D reform eliminating the 5 percent coinsurance for the catastrophic phase. Our educational webinar will help patients understand the reforms and changes to assistance amounts.
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Hosting health equity webinar about rural communities
As part of the PAN Foundation’s Health Equity in Action webinar series with CVS Specialty, we will host our final webinar on December 12 at 1:00pm ET focused on addressing the needs of rural communities. Dr. Dara Richardson-Heron will join us again to moderate this important discussion with our guest speakers:
- Gabriela Boscan, Senior Director of Program Services and Development, National Rural Health Association
- Michael Burson, DEI Consultant, Sanford Health
- Dr. Catherine Ipsen, Director, Research and Training Center of Disability in Rural Communities
- Morgan O’Brien, Director of Community Relations, Family Reach Foundation
The goal of this webinar is to explore the unique healthcare access challenges faced by healthcare providers and people living in rural communities and identify key strategies to help mitigate these challenges.
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Media coverage around alternative funding programs
The PAN Foundation’s Chief Advocacy and Engagement Officer, Amy Niles, recently authored a column in Oncolytics Today highlighting how alternative funding programs (AFPs) work, how they are hurting patients, and what can be done to address them. In addition, she outlines what PAN is doing specifically to address these harmful programs and calls on Congress to put patients first by banning AFPs.
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Upcoming conferences
As we look towards the end of 2023, there are a few key industry conferences where we will speak, exhibit, and attend in the next two months. We hope to see you there!
BioNJ Patient Advocacy Summit (November 16 in Princeton, NJ)
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November 16: Our Chief Advocacy and Engagement Officer, Amy Niles, will participate in a panel discussion about alternative funding programs and their harm to patients.
Reuters Pharma & Patient USA (November 16-17 in Philadelphia, PA)
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November 17: Our Chief Advocacy and Engagement Officer, Amy Niles, will moderate a panel discussion with patients exploring access and affordability challenges they face while navigating chronic, rare, and life-threatening disease diagnoses.
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Visit us at our exhibit booth—Booth #27.
- Reach out to Leena to schedule an in-person meeting.
ASH's Annual Meeting and Expo (December 9-12 in San Diego, CA)
- Reach out to Mira and Lindsey to schedule an in-person meeting.
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PAN's disease fund creation process
As a charitable patient assistance foundation, PAN is committed to compliance, transparency, and operational excellence, which includes complying with all federal laws, regulations, and guidelines. To meet these requirements, PAN implements an independent, standardized process for identifying and launching new disease funds, including adopting key operational safeguards. Our comprehensive disease fund development process includes:
- Identifying a prospective disease fund through rigorous ongoing research
- Preparing a comprehensive dossier with the parameters of the disease fund
- Reviewing with medical experts including our Medical Director to confirm the fund is clinically compliant
- Reviewing with our external legal counsel to confirm the fund is OIG compliant
- Approving the fund by our Board of Directors Patient Assistance Committee
- Launching the new disease fund once a donation is received
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When she was first diagnosed with pulmonary arterial hypertension, Janice Turner was in shock and wasn’t sure she could afford her medications and oxygen. Thankfully, she found the PAN Foundation and got the financial help she needed. We’re committed to helping patients like Janice receive the medications they need and improve their quality of life. | |
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Dignity. Excellence. Integrity. Intention. | | | | |
