New Medicare Program Enhances Affordability for Oral Cancer Medications with Early Enrollment Opportunities

A recent policy update in Medicare has the potential to significantly reduce the financial burden for cancer patients taking oral medications. Prior to 2025, many Medicare beneficiaries faced annual out-of-pocket costs exceeding $10,000 for lifesaving cancer drugs, posing a risk that some might abandon their treatments due to high expenses. The Inflation Reduction Act (IRA), which took effect this year, introduced critical changes, including capping annual out-of-pocket expenditures at $2,000 for all Medicare Part D beneficiaries.

An often-overlooked aspect of this legislation is the voluntary Medicare Prescription Payment Plan (MPPP), which offers patients the option to spread their out-of-pocket costs into manageable monthly payments. Researchers from the Perelman School of Medicine at the University of Pennsylvania analyzed the impact of these policies and found that early enrollment in the MPPP could drastically improve affordability. For instance, spreading the $2,000 cost over 12 months would reduce monthly payments to roughly $167, easing financial pressure.

The study examined ten high-prevalence oral cancer drugs, revealing that before the IRA, annual patient costs for these medications could reach over $20,000, with the first months of the year being particularly burdensome. The IRA's caps mean costs are now limited to $2,000 annually, a substantial decrease, but the initial costs in January still pose a challenge, leading to treatment discontinuation for some patients.

By enrolling early in the year, patients can benefit from the MPPP, which allows for spreading out payments, making expensive treatments more accessible. Healthcare providers have a key role in informing their patients about this option, especially since early enrollment can maximize financial relief and treatment adherence.

This policy shift offers a promising path to improve treatment continuity and outcomes for cancer patients on Medicare, emphasizing the importance of early engagement with the MPPP to capitalize on these benefits.

Source: https://medicalxpress.com/news/2025-04-medicare-cancer-drugs-patients-enroll.html