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Pharma study shows benefit of copay assistance for high-cost prescriptions

Pharma Study Shows Benefit Of Copay Assistance For High-cost Prescriptions

Besides being a financial issue for pharmaceutical companies, unfilled prescriptions can lead to poorer health outcomes, drive up overall cost of care, and can have an impact on provider performance under value-based payment models.

Pharmaceutical companies often use copay assistance programs to support patients who need to overcome financial barriers in filling their prescriptions. These financial barriers continue to be a significant problem. A poll from Truven Health Analytics-NPR found that cost is the top cause of unfilled prescriptions, with 67% not taking their medications for this reason.

But does copay assistance actually work to increase adherence? According to one recent study for a class of oral anticancer drugs, it does.

Copay assistance reduced patient non-adherence by 88% for cancer drug

A study published February 2019 in the Journal of Medical Economics, “The impact of copay assistance on patient out-of-pocket costs and treatment rates with ALK inhibitors,” measures the effect of copay assistance on patient access and adherence for nonsmall cell lung cancer patients taking these drugs. While ALK inhibitors are not the most expensive anticancer drugs, the cost burden for these patients, even with insurance, can be significant. For example, the general list price for a 30-day course of treatment of one of these drugs, Lorbrena, can range between more than $5,000 a month to more than $15,000 a month, depending on the dosage. Of course, co-pays are much less than these amounts, but still can be significant in high-deductible insurance plans and for Medicare patients.

In the study, investigators looked at patterns of claims, out of pocket costs, and treatment persistence reported over four years in the IQVIA Formulary Impact Analyzer. More than 3,000 patients with and without copay assistance were included in claims data analysis, and over 1,500 patients were analyzed for treatment persistence. Co-pay assistance included manufacturer’s copay cards, other discount cards, or free-trial vouchers.

Why was the study done at all? In nonsmall lung cancer, treatment delays are associated with a poorer prognosis. A 2017 study in the Journal of Clinical Oncology found that initiating treatment for early stage nonsmall cell lung cancer patients within four weeks of diagnosis was associated with lower risk of death.

Lower out-of-pocket costs linked to better adherence

The study found that for patients who received copay assistance, better adherence and lower out-of-pocket costs were linked.

  • Patients with copay assistance had an 88% lower risk of abandoning their first prescription
  • Patient out-of-pocket cost decreased an average of $1,900
  • Patients started treatment sooner: on average in 3 days, as opposed to 26 days for patients without copay assistance

The takeaway? Patients and brand marketers would benefit if pharmaceutical companies increased efforts to offer patients co-pay assistance and educate providers, especially for high-cost drugs where there are significant barriers to patient adherence.

About AllazoHealth

AllazoHealth uses artificial intelligence to make a positive impact on individual patient adherence. We help pharmaceutical companies optimize their patient support programs to overcome barriers to adherence for at-risk patients. The result: better patient outcomes, and increased persistence.

Case Study: Leading pharma brand achieves increased days on therapy

Copay assistance shows days on therapy uplift

Learn how AllazoHealth used AI to optimize patient engagement in a leading pharmaceutical company’s patient support program.