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

Abstract

Background: Lack of insurance coverage in conjunction with the high cost of prescription drugs plays a large role in patient’s obtaining and properly taking their medications. Many drug manufacturers provide assistance opportunities for indigent patients lacking the financial means to obtain the medication. It is hypothesized that providing a dedicated insourced team to coordinate this process can successfully increase medication access for indigent patient populations. Methods: Patients with little or no means for payment whom the patient assistance team was contacted to obtain a medication were included. Information collected included the medication requested, the drug manufacturer, the cost of the medication, the dose required, the number of doses approved, and whether the request was approved or denied. This data was analyzed for approval rate, most common medications requested, total cost of medications provided, as well as which system hospitals are utilizing the program most frequently. Results: In total, 153 patients were assessed to obtain medication assistance through the program. With an overall approval rate of 59.5%, 91 patients were provided medication through this program. 58% of patients received insurance approval and were therefore denied no-cost drug. The program was able to obtain 283 fills of no-cost medications for patients with a total value of $2 060 633.83. Conclusion: A dedicated patient assistance program is effective in obtaining financial assistance for patients to obtain high-cost medications for which they otherwise could not provide payment. With the continued expansion of biologic medication development, the necessity for programs to aid indigent populations increases exponentially.