Ocrevus co pay assistance program12/15/2023 ![]() ![]() 7ĭespite the growth in PAPs, there is no broad consensus regarding the practice’s overall impact on pharmaceutical access and costs. 6 Another study estimated that 46% of claims for specialty drugs treating multiple sclerosis (MS) used PAPs, producing an average 61% reduction in OOP charges. ![]() 5 One source with access to PAP data found that the practice is growing in prevalence and, in 2018, was used in an estimated 18% of all branded prescriptions and 42% of all specialty prescriptions. The use of PAPs can be difficult to track, however, and their use is generally omitted from claims analysis. 3, 4 The use of PAPs can be suggested by a physician if a patient has concerns about covering a drug cost or patients can learn about discount programs via television commercials, online advertisements, or search engine results, and redemption materials can be printed out online, sent in the mail, or requested at the pharmacy. A practice that emerged in the mid-2000s, PAPs are defined as a drug manufacturer paying for some or all of a patient’s OOP charges at the point of sale. 1, 2Ī significant omission in this conversation, however, is manufacturer-provided patient OOP assistance, also referred to as copay coupons or as patient assistance programs (PAPs). 1 The specific concern is that out-of-pocket (OOP) costs are too high, disincentivizing optimal medication use through lowered adherence, skipped prescriptions, or discontinued use. There is an ongoing public conversation about patient drug costs in the United States and how those costs can affect patient access and adherence to necessary medication. PED estimates were not statistically significant by drug, and the exclusion of Medicare patients did not change this interpretation.Īccess to OOP cost subsidization was not associated with a change in patient demand for multiple sclerosis drugs in our study population, although there was significant selection bias for those with high OOP charges to seek financial assistance. An average change in price of −$168.21 with PAP use led to an average change in demand of −0.05 days, for an overall price elasticity of demand (SD = 0.028, P = 0.852) given PAP use of 0.005, indicating that the presence of PAPs did not significantly affect demand. The probability of a patient having a drug claim in a given month was 1.9% higher among those using patient assistance, although this finding was not significant ( P = 0.258). Total claim amount was higher for claims that used assistance ($6,169) than claims that did not ($5,503, P < 0.001). The OOP costs charged to patients was higher for claims where patient assistance was used than claims where assistance was not used ($294 vs $42, P < 0.001). People who used PAPs had much higher OOP charges, a lower Charlson comorbidity score, and were more likely to have insurance through an exchange. ![]() When used, copay assistance covered 100% of out-of-pocket (OOP) charges for 98% of claims and reduced patient annual OOP cost by $3,493 on average. ![]() Of 789 unique patients, 480 (60.7%) used PAPs in at least 1 drug claim during the 13-month time frame, and 248 patients (31.4%) used PAPs for all of their MS drug claims. ![]()
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