Taiho Oral Oncology Drug Reimbursement Knowledge Review

13 Questions | Total Attempts: 83

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Drug Quizzes & Trivia

Questions and Answers
  • 1. 
    Which ONE of the following statements is true?
    • A. 

      Medicare is a single payer with consistent coverage processes for prescription drugs

    • B. 

      Medicare has three benefit programs, two of which cover prescription drugs

    • C. 

      Medicare consists of four benefit programs, two of which cover prescription drugs

    • D. 

      None of the above

  • 2. 
    What is the average range of patient coinsurance cost share for oral oncology drugs under MAPD/PDP plans?
    • A. 

      20-25%

    • B. 

      30-35%

    • C. 

      25-33%

    • D. 

      None of the above

  • 3. 
    Which of the following statements will likely apply at market launch with commercial payers and MAPD/PDPs for Taiho's new product?
    • A. 

      The drug will likely have a prior authorization requirement

    • B. 

      The drug's coverage will match the FDA approved label

    • C. 

      The drug will likely be positioned on a specialty tier within the payer's formulary

    • D. 

      All of the above

    • E. 

      None of the above

  • 4. 
    True or false - a patient that has Medicare Part B benefits automatically has a prescription drug benefit.
    • A. 

      True

    • B. 

      False

  • 5. 
    True or false - when a Medicare beneficiary covered under original Medicare (Part A and B) decides to enroll in a stand-alone Part D plan, the premium for the Part D plan is rolled into the Part A/B premium.
    • A. 

      True

    • B. 

      False

  • 6. 
    Which of the following statements is true (select one only)?
    • A. 

      Medicare Part D plan premiums, formulary design and patient cost share are all consistent across the US, based on Federal regulations

    • B. 

      Medicare Part D plan premiums are consistent across the US, but each Part D plan can create their own formulary and cost share design

    • C. 

      Medicare Part D formularies are the same across the US, but premiums and cost share may vary by plan

    • D. 

      Medicare Part D premiums, formularies and patient cost share can vary from plan to plan

  • 7. 
    Under which of the following Medicare benefits will a cancer patient be able to have coverage for oral oncology drug benefits? 
    • A. 

      Medicare Part A

    • B. 

      Medicare Part B

    • C. 

      Medicare Part C

    • D. 

      Medicare Part D

    • E. 

      Medicare Advantage

    • F. 

      MAPD plans

    • G. 

      PDPs

  • 8. 
    Which of the following are the most common resources used by payers to support coverage decisions for new FDA approved oral oncology drugs (select all that apply)?
    • A. 

      FDA approval letter

    • B. 

      Most recent ASCO abstracts

    • C. 

      FDA approved product label

    • D. 

      Health technology assessments

    • E. 

      Clinical compendia publications

    • F. 

      All of the above

    • G. 

      None of the above

  • 9. 
    True or false - Each state Medicaid fee-for-service agency may differ in how they cover an oral oncology drug.
    • A. 

      True

    • B. 

      False

  • 10. 
    In which of the following ways might commercial payers/plans manage the utilization of oral oncology drugs (select all that apply)?
    • A. 

      Comprehensive prior authorizations

    • B. 

      Quantity limits (limiting the number of pills/tablets dispensed per month)

    • C. 

      Formulary tier differentials

    • D. 

      Differing patient copay or coinsurance

    • E. 

      All of the above

  • 11. 
    If a Medicare beneficiary is covered by a Medicare Advantage plan, which of the following statements is true?
    • A. 

      The beneficiary will have medical benefits but not pharmacy benefits and will be required to purchase a separate Part D plan

    • B. 

      The beneficiary's current Medicare Part A/B premium level will match the Medicare Advantage plan's premium

    • C. 

      A beneficiary covered under Medicare Advantage cannot purchase a Medicare supplement/Medigap policy to cover the remaining patient cost share responsibility

    • D. 

      All of the above

  • 12. 
    True or false - Even if a physician office does not have an onsite pharmacy, that practice is responsible for all work required to process a drug prior authorization to ensure that the utilization of an oral oncology drug is appropriate.
    • A. 

      True

    • B. 

      False

  • 13. 
    Which of the following represent the most common access points from which a patient may obtain their oral oncology drug prescription (select all that apply)?
    • A. 

      Community retail pharmacies

    • B. 

      Specialty pharmacies contracted by payers

    • C. 

      Long-term care and home health pharmacies

    • D. 

      Physician offices (through onsite pharmacies or physician dispensing)

    • E. 

      Hospital outpatient pharmacies (whether 340B eligible or not)

    • F. 

      340B contracted pharmacies

    • G. 

      All of the above

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