Accessing patient assistance programs to meet clients' medication needs

Enhancing access to expensive oncology medications in Pakistan: The critical role of pharmaceutical patient assistance programs in oncology care

This article aims to explore the access of patient assistance program (PAPs) and the role of pharmacists in improving access to oncology care in Pakistan. PAPs aim to reduce the financial burden of cancer in Pakistan, with pharmaceutical companies providing medication at reduced costs, ranging from 33% to 90%. Pharmacists play a pivotal role in managing these programs, facilitating PAP, pharmacist, oncology care setting, cancer therapy more accessible to those who faced financial barriers to accessing them.

Cancer patients' use of pharmaceutical patient assistance programs in the outpatient pharmacy at a large tertiary cancer center

PURPOSE: To report on the use of pharmaceutical patient assistance programs (PAPs) in the outpatient pharmacy at the largest tertiary cancer center in the United States. METHODS: We conducted a retrospective (July 1, 2006-Dec 31,2007) cross-sectional analysis of outpatient pharmacy, medical, and cancer registry records at the cancer center. The cancer center identified 104 medications available through PAPs. Study-eligible patients received at least one of these medications, either as a PAP case patient or as a PAP control non-user. Binary logit regression models predicted PAP use, and descriptive statistics compared PAP user and non-user medication fills. RESULTS: Of 25,552 cancer patients at who received an outpatient medication during the study period, 1,929 met study criteria (n=950 PAP users, 979 PAP non-users). In comparison to controls, PAP users were more likely to be uninsured (odds ratio (OR)=4.60, 95% confidence interval (CI): 2.118, 9.970), indigent (OR=16.95, 95% CI: 6.845, 41.960), and < 65 years old (OR=2.31, 95% CI: 1.517, 3.509). Of the most frequently dispensed medications to PAP users from PAPs (n=5,271), 88% (n=4,936) were for supportive care (e.g., nausea/vomiting). PAPs provided 35% (n=842) of the most common anticancer agents administered to PAP users (n=1,296), accounting for a monthly mean of $55,000 in pharmaceutical expenditures. CONCLUSIONS: In the cancer center's outpatient pharmacy, PAPs provided financial support for about a third of the most commonly used therapies, primarily for supportive care indications, for a small percentage of eligible cancer patients.

Food insecurity among cancer patients in kentucky: a pilot study

PURPOSE

Food insecurity is defined as being uncertain of having enough food due to insufficient money or other resources. The purpose of this study was to examine the construct and correlates of food insecurity in a sample of cancer patients in Kentucky.

PATIENTS AND METHODS

Data were collected in the waiting rooms of the chemotherapy, hematology/oncology, and gynecology/oncology clinics of a university cancer center, and included 115 cancer patients actively receiving treatment (mean age, 55.85 years; range, 23 to 88 years) who completed a series of standardized measures to assess food insecurity status and psychological and nutritional well-being. Descriptive statistics and independent samples t tests were used to assess the prevalence of food insecurity in the sample, and to identify differences between the persons who were food insecure and food secure.

RESULTS

The prevalence rates of food insecurity and food insecurity with hunger in the sample were 17.4% and 7.8%, respectively, which are higher than in the general population. Food-insecure patients had statistically significant higher levels of nutritional risk, depression, and financial strain, and lower quality of life compared with food secure patients. Fifty-five percent of food insecure patients reported not taking a prescribed medication because they could not afford it, versus 12.8% of food-secure patients (P = .002).

CONCLUSION

Food insecurity may be an important consideration for clinical oncology practice, especially when caring for individuals of lower socioeconomic status. Further study is warranted, including prospective studies of cancer patients to identify causal relationships among food insecurity, cancer incidence, cancer treatments, and patient outcomes and well-being.

What is the evidence for pharmaceutical patient assistance programs? A systematic review

Pharmaceutical patient assistance programs (PAPs) have the potential to improve prescription drug accessibility for eligible patients, but currently there is limited information regarding their effectiveness. In an attempt to provide a systematic description of primary studies on PAPs, we reviewed 33 unique studies from commercial and grey literature (e.g., government publications, conference abstracts) sources: 15 health care outcome evaluations, seven economic evaluations, seven surveys and four miscellaneous studies. Enrollment assistance for PAPs with additional medication services (e.g., counseling) was significantly associated with improved glycemic (standardized mean difference=-0.40, 95% CI=-0.59,-0.20; k=3 one-group, pre-post-test; 1 comparison-group) and lipid (standardized mean difference=-0.52, 95% CI=0.78,-0.27; k=3 one-group, pre-post-test; 1 comparison group) control. Inadequately designed economic evaluations suggest free PAP medications offset health care institutions' costs for uncompensated medications and enrollment assistance programs. More rigorous research is needed to establish the clinical and cost-effectiveness of PAPs from a patient and health care institution perspective.

Pharmaceuticals companies' medication assistance programs: potentially useful but too burdensome to use?

OBJECTIVES

This study examined how physicians perceive pharmaceutical companies' medication assistance programs (MAPs).

METHODS

The study was conducted using a survey of 373 primary care physicians from four southern states; they were surveyed within the formative evaluation phase of a larger study (MI-Plus). Respondents were queried about use and usefulness of MAPs for patients who cannot afford drugs, and barriers to using them. Bivariate associations between physician-level variables (patients without drug coverage) and usefulness and barriers to using MAPs were assessed using Chi square tests. Independence of associations was assessed using multiple logistic regressions.

RESULTS

Of the 364 (97.6%) respondents who used MAPs, 70% used them regularly, the rest occasionally; 63% found MAPs very useful in caring for patients who could not afford drugs. About 89% reported one or more barriers to using MAPs; 47% saw "inability of patients to apply directly;" and 57% saw "enrollment process being time-consuming for staff" as barriers. Compared to physicians with fewer elderly patients without drug coverage, those with more of these patients were less likely to find MAPs very useful; less likely to report no barriers to using MAPs; and more likely to see "low income thresholds" and "inability of patients to apply directly" as barriers.

CONCLUSION

While MAPs are considered useful in caring for patients in need of assistance, there are many barriers to their use. Pharmaceutical companies should address these barriers. Limitations include a low response rate (about 10%).

The impact of 'social determinants of health' on epilepsy prevalence and reported medication use

There is a limited understanding of the complex relationship between poverty and epilepsy. To address the complex interaction of environmental and psychosocial factors in epilepsy a 'social determinants of health' model is presented where individual factors are influenced through three pathways (social environment, work and material factors). In the 2005 California Health Interview Survey, 246 of 604 (41%) persons with a history of epilepsy were in poverty, defined as <200% Federal Poverty Level (FPL). Multivariable logistic regression analyses revealed persons in poverty are not more likely to report a history of epilepsy compared to those not in poverty. However, persons with a history of epilepsy in poverty were significantly less likely than those not in poverty to report taking medication for epilepsy (OR 0.5) once material factors (annual income and living situation) and healthcare access were controlled for in the final sequential model. Healthcare practitioners must continue to recognize that connection to social services and the cost of medications are significant barriers to optimal care in persons with epilepsy. Improved connection to patient advocacy organizations and medication assistance programs may help close these gaps.