TABLE 3.
Impact of Financial Medication Assistance on Patient Out-of-Pocket Costs and Clinical Outcomes
| Author year (journal) | Impact on patient out-of-pocket costs | Impact on clinical outcome |
|---|---|---|
| CARDIOVASCULAR: Program/pharmacy service | ||
| Marrs 200819 (Pharmacotherapy) | Not reported | LDL: Proportion of patients reaching LDL goals in the indigent intervention group (68.9%) were not significantly greater than the insured group (78.4%; P = 0.34). |
| Schoen 201120 (Pharmacotherapy) | Not reported | INR: In patients receiving warfarin, mean INR increased from 2.44 ± 0.64 at baseline to 2.61 ± 0.53 at 6 months (P < 0.05). SBP/DBP: In patients with hypertension, mean blood pressure decreased from 138 ± 20/80 ± 11 mm Hg at baseline to 138 ± 19/78 ± 12 mm Hg at 6 months (P < 0.05 for diastolic blood pressure only). LDL: The mean LDL level for patients on lipid-lowering drugs significantly decreased from 126 ± 39 mg/dl at baseline to 108 ± 38 mg/dl at 6 months (P<0.001). For each disease measure, the improved disease control seen at 6 months persisted throughout 24 months of follow-up. Hospitalization: Hospitalizations for the entire cohort decreased from 85 at baseline to 49 at 6 months. |
| CARDIOVASCULAR: Discount card | ||
| Knott 201521 (Health Policy) | Not reported | Not reported |
| CARDIOVASCULAR: Manufacturer coupon | ||
| Daugherty 201322 (JMCP) | Mean costs over 12 months Brand coupon users: $194 (post-coupon) Brand noncoupon users: $169 (P < 0.001) Generic users: $53 (P value not reported) |
Not reported |
| Daubresse 201723 (Pharmacotherapy) | All coupon users had consistently lower OOP costs than noncoupon users. At 1 year, average monthly out-of-pocket costs for statins appeared $5 lower for initial coupon users than for noncoupon users; however, this difference was not statistically significant ($9.7 vs $15.9, not significant). Between 2 and 4 years of follow-up, this difference persisted, ranging from $2 to $6. | Not reported |
| CARDIOVASCULAR: Voucher | ||
| Wang 201924 (JAMA) | Not reported | MACE: There was no significant difference in MACE at 1 year between intervention (randomized to a hospital that received P2Y12 inhibitor vouchers to provide to their patients) and usual care groups (unadjusted cumulative incidence, 10.2% vs 10.6%; P = 0.65; adjusted difference, 0.66% [95% CI, −0.73%to 2.06%]; adjusted hazard ratio, 1.07 [95% CI, 0.93 to 1.25]). |
| Fanaroff 202025 (JAMA Cardiology) | Over the 1-year study period, patients in the intervention arm (randomized to a hospital that received P2Y12 inhibitor vouchers to provide to their patients) had higher median (IQR) monthly OOP costs for all filled prescriptions than patients receiving usual care (median [IQR], $26.99 [$9.46-$62.12] vs $24.36 [$7.78-$55.21]; P < 0.001). | Not reported |
| CANCER: Manufacturer copay card, discount card, or voucher | ||
| Seetasith 201926 (Journal of Medical Economics) | Patients with copay assistance had lower mean OOP costs for their first approved ALKi than patients without copay assistance (mean [SD] = $26 [$229] vs $1,205 [$3,543], P < 0.001). | Not reported |
ALKi = anaplastic lymphoma kinase inhibitor; CI = confidence interval; INR = international normalized ratio; IQR = interquartile range; JAMA = Journal of the American Medical Association; JMCP = Journal of Managed Care & Specialty Pharmacy; LDL = low-density lipoprotein; MACE = major adverse cardiovascular event (death, recurrent myocardial infarction, or stroke); OOP = out-of-pocket; SBP/DBP = systolic blood pressure/diastolic blood pressure; SD = standard deviation.