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AP-004

Myeloma, 65 to 74, suburban, Medicare Advantage

CAR-T · Phase 2, Candidacy Evaluation · 14 days in stage · 5 barriers, 2 blocking

On track

The engine, inverted

By factor

Each row is one fact about this patient and everything it sets in motion. 1 of 3 factors drive more than one barrier, which is where addressing the cause beats addressing the symptoms.

Modest / limited income

drives 2 barriers

Household income

  • Travel & lodging burdenWatch

    On a limited income, uncovered travel and lodging can be the deciding factor in whether the patient actually shows up

  • Financial toxicity / out-of-pocket burdenWatch

    Copays, ancillary drugs, and travel stack up quickly and, on a limited income, crowd out essentials

2+ prior lines of therapy

drives 1 barrier

Line of therapy

  • Late referral / progression before treatmentWatch

    With 2+ lines already used, the window to refer while still eligible is closing

Medicare Advantage

drives 1 barrier

Insurance

  • Insurance coverage & prior-authorizationWatch

    Medicare Advantage plans often add step-therapy and prior-auth hurdles that delay authorization