Assessment of an In-Sourced Patient Assistance Program at a Health System in West Virginia

Area of Science:

• Health Economics
• Pharmaceutical Access
• Patient Support Programs

Background:

• High prescription drug costs and lack of insurance coverage create significant barriers to medication access for patients.
• Pharmaceutical manufacturers offer patient assistance programs (PAPs) to support indigent individuals.
• A hypothesis proposed that an insourced patient assistance team could improve medication access for underserved populations.

Purpose of the Study:

• To evaluate the effectiveness of a dedicated, insourced patient assistance team in securing medications for indigent patients.
• To analyze the impact of the program on medication access, approval rates, and financial assistance obtained.

Main Methods:

• Retrospective analysis of patients referred to the patient assistance team for medication procurement.
• Data collection included medication details, manufacturer, cost, dosage, and approval status.
• Analysis focused on approval rates, common medications, total value of medications provided, and program utilization.

Main Results:

• The program assessed 153 patients, securing medication assistance for 91 (59.5% approval rate).
• The program facilitated 283 no-cost medication fills, valued at over $2 million.
• 58% of patients were denied no-cost drugs due to existing insurance coverage.

Conclusions:

• A dedicated patient assistance program is a viable strategy for improving access to high-cost medications for patients facing financial hardship.
• The increasing development of biologic medications underscores the growing need for robust patient assistance initiatives.
• Such programs are crucial for ensuring equitable access to essential treatments for indigent patient populations.