New data underscores the need for affordable,
effective bowel preparation medications
MINNEAPOLIS, July 2, 2024
/PRNewswire/ -- A new study reveals that many patients are still
paying out of pocket for bowel preparations needed for colonoscopy,
despite a federal law that says these should be covered by
insurance. The study, led by Dr. Eric D.
Shah from the University of
Michigan and his team, highlights the unnecessary financial
burdens that can affect patient compliance with essential
colorectal cancer (CRC) screening.
The study, which analyzed nearly 2.6 million insurance claims
from May 2022 to April 2023, looked at how many patients paid for
bowel prep medications needed for colonoscopy. Claims came from
both commercial insurance plans and Medicare Part D.
Overall, when considering that nearly 50% of patients are
cost-shifted toward the use of non-FDA approved over-the-counter
regimens, the data suggest that only 17% of patients pay zero for
their bowel preparation for screening colonoscopy. Of the
prescription claims analyzed, only 36% had no out-of-pocket costs.
Additionally, high-volume preps were more likely to be free
compared to new, low-volume or tablet preparations. However, when
patients did pay, high-volume preps cost a median of $10, while low-volume preps cost $60. For Medicare Part D, only 25% of high-volume
preps were free, compared to 10% for low-volume
preps.i
The Colon Cancer Coalition, a national nonprofit committed to
helping increase screening and prevention for CRC, is raising
awareness of this issue, emphasizing the need for affordable and
effective bowel preparation medications.
"As advocates for colorectal cancer screening and prevention,
it's disheartening to see that so many patients are responsible for
at least a portion of the cost of bowel preparation medication
required for colonoscopy," said Chris
Evans, President, Colon Cancer Coalition. "Equally as
frustrating is that patients are paying even more for new, more
modern, low-volume or tablet bowel preps that have been proven more
effective and tolerable. All patients should have the ability to
choose a quality bowel prep that works best for them, regardless of
financial situation. Reducing barriers to quality prep, including
cost, is important in ensuring more patients undergo this
life-saving procedure."
The Affordable Care Act (ACA) requires that certain preventative
services, including CRC screening, must be covered by insurance
plans without cost-sharing for patients.ii This means
that patients should not have to pay for these services to ensure
that financial barriers do not prevent patients from undergoing
necessary screenings for CRC.ii Unfortunately,
prescription bowel prep for screening colonoscopy is still subject
to cost sharing for most patients, running contrary to the ACA's
mandate, and to the detriment of patients.
To learn more about the study, visit eposters.ddw.org, for
more about patient choice and options for colonoscopy prep or
coloncancercoalition.org.
About Colon Cancer Coalition
The Colon Cancer
Coalition is dedicated to encouraging screening, reducing barriers
to access, and raising awareness of the signs and symptoms of
colorectal cancer. The organization's signature Get Your Rear in
Gear® event series is volunteer-driven in communities
across North America. Annually,
the Colon Cancer Coalition grants over $1
million dollars to local communities to build and sustain
programs promoting prevention, on-time screening, and
quality-of-life research, as well as patient support efforts for
those living with this disease. By making the words colon,
colorectal and colonoscopy a part of everyday language, we believe
we can overcome the fear and decrease deaths from this largely
preventable cancer. For more information visit
ColonCancerCoalition.org.
For further information, contact:
Logan Campbell, HAVAS Red
Logan.Campbell@havasred.com
724-987-2781
Erin Peterson, Colon Cancer
Coalition
erin@coloncancercoalition.org
651-247-4023
References:
______________________________
i Shah, E. D., Calderwood, A. H., & Halberg, D.
L. (2024, May). Most patients have out-of-pocket costs for colon
preps associated with CRC screening, contrary to the ACA mandate: A
real-world analysis from a large dataset. Poster presented at
Digestive Disease Week, Washington,
D.C.
ii U.S. Department of Health and Human Services.
(2016, April 20). FAQs about
Affordable Care Act implementation (Part 31).
https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/FAQs%2031_Final%204-20-16.pdf
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SOURCE Colon Cancer Coalition