Three Patient-Assistance Program Strategies to Bolster ROI
Healthcare affordability continues to be a struggle for many in the U.S. While the country grapples with changing views on government-mandated health insurance, millions are still either uninsured or underinsured. In fact, the underinsured population, defined as those who have insurance but can't afford monthly co-pays and out-of-pocket expenses, is still estimated to be nearly 30 million people.
Launched in the 1950s, PAPs served to help uninsured patients who needed to access therapies. Pharmaceutical companies provided services to individuals based on their eligibility criteria and application process. The concept of PAPs has changed very little since then, and many more biopharmaceutical companies, foundations, and advocacy groups offer these programs today. In the world of specialty, orphan, and ultra-orphan drugs, where the cost of a single dosage can be thousands of dollars, PAPs play a strategic role in getting patients access to therapies that often prove lifesaving.
While many biopharmaceutical companies are currently investing in PAPs, few are taking the extra steps needed to increase conversion, build brand value, and drive ROI. The following key steps are important to optimize the value of your PAP.
1. Set time limits.
Biopharmaceutical companies should determine how long they will provide assistance and focus their efforts on converting patients to commercial or government coverage before the patient enrolls for renewal. Most PAP programs provide assistance for one year. After the first year, a patient must then re-enroll and requalify. Some companies even offer two-year programs.
2. Budget your program based on the needs and demographics of your patient population.
Traditionally, biopharma companies forecast that an average of 10% to 15% of their population will meet the eligibility criteria required for PAP. The next step is to closely examine the patient population to verify that this is accurate. How many patients are on Medicare? Are any on fixed incomes? Does the therapy serve a youth population? By examining the demographics of the patient population to look for traits and trends, whether by economic status or geographic area, biopharma companies can more closely estimate how much to invest in their PAP.
3. Build relationships through patient advocacy, specialty society, and foundational support groups.
These groups play an important role in funding both research and PAPs because they can help patients with co-pay assistance, premium assistance, and out-of-pocket expenses. By forming solid relationships with these groups, biopharma companies can recommend additional support opportunities to patients.