Low use of guideline-recommended treatment among Medicare Advantage and traditional Medicare beneficiaries with advanced lung cancer

Medicare Advantage (MA) plans have grown in popularity and currently cover over half of all beneficiaries [1]. Although MA plans offer supplemental benefits and out-of-pocket maximums [2], they also employ numerous strategies to control health care spending. Specifically, MA plans often restrict care to in-network providers and require utilization management (e.g., prior authorization, step therapy) for nearly all self- and clinician-administered anticancer therapies [1]. Evidence suggests that MA enrollment is associated with a low likelihood of starting any or high-cost systemic therapies among beneficiaries with advanced lung cancer [1,3], raising concerns that cost-containment strategies could limit access to guideline-recommended care.