A Copay Foundation Assistance Support Program for Patients Receiving Intravenous Cancer Therapy

Rajurkar, Swapnil; Presant, Cary A.; Bosserman, Linda D.; McNatt, Wendy

doi:10.1200/jop.2010.000112

Cited by 17 publications

(15 citation statements)

References 7 publications

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“…However, our study provides a unique window into the lives of the underinsured cancer patient. Data suggest that many patients with cancer are underinsured and may benefit from financial assistance , but the exact percentage of patients who receive such assistance is unknown. Finally, we were not able to collect data on eligible participants who declined study participation, and thus, we could not assess for selection bias.…”

Section: Discussionmentioning

confidence: 99%

“…However, our study provides a unique window into the lives of the underinsured cancer patient. Data suggest that many patients with cancer are underinsured and may benefit from financial assistance [4,37], but the exact percentage of patients who receive such The adjusted p-values are based on an analysis of variance model with the other variables in Table 3 used as covariates.…”

Section: Discussionmentioning

confidence: 99%

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Identifying cancer patients who alter care or lifestyle due to treatment‐related financial distress

et al. 2015

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As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

“…However, our study provides a unique window into the lives of the underinsured cancer patient. Data suggest that many patients with cancer are underinsured and may benefit from financial assistance [4,37], but the exact percentage of patients who receive such The adjusted p-values are based on an analysis of variance model with the other variables in Table 3 used as covariates.…”

Section: Discussionmentioning

confidence: 99%

Identifying cancer patients who alter care or lifestyle due to treatment‐related financial distress

et al. 2015

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“…These out-of-pocket-related expenses are higher among patients with cancer than among patients with other conditions [3,4]. As a result of growing expenses, even patients with insurance may require financial assistance from government or nonprofit national copayment assistance organizations to guarantee access to therapy and to mitigate the financial burden of cancer care [5]. Though the number of insured patients is estimated to increase in the era of the Affordable Care Act, rising out-of-pocket costs dispute the adequacy of insurance for providing affordable cancer care [6,7].…”

Section: Introductionmentioning

confidence: 99%

The Financial Toxicity of Cancer Treatment: A Pilot Study Assessing Out-of-Pocket Expenses and the Insured Cancer Patient's Experience

et al. 2013

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Purpose. Cancer patients carry rising burdens of health carerelated out-of-pocket expenses, and a growing number of patients are considered "underinsured." Our objective was to describe experiences of insured cancer patients requesting copayment assistance and to describe the impact of health care expenses on well-being and treatment. Methods. We conducted baseline and follow-up surveys regarding the impact of health care costs on well-being and treatment among cancer patients who contacted a national copayment assistance foundation along with a comparison sample of patients treated at an academic medical center. Results. Among 254 participants, 75% applied for drug copayment assistance. Forty-two percent of participants reported a significant or catastrophic subjective financial burden; 68% cut back on leisure activities, 46% reduced spending on food and clothing, and 46% used savings to defray out-of-pocket expenses. To save money, 20% took less than the prescribed amount of medication, 19% partially filled prescriptions, and 24% avoided filling prescriptions altogether. Copayment assistance applicants were more likely than nonapplicants to employ at least one of these strategies to defray costs (98% vs. 78%). In an adjusted analysis, younger age, larger household size, applying for copayment assistance, and communicating with physicians about costs were associated with greater subjective financial burden. Conclusion. Insured patients undergoing cancer treatment and seeking copayment assistance experience considerable subjective financial burden, and they may alter their care to defray out-of-pocket expenses. Health insurance does not eliminate financial distress or health disparities among cancer patients. Future research should investigate coverage thresholds that minimize adverse financial outcomes and identify cancer patients at greatest risk for financial toxicity. TheOncologist 2013;18:381-390Implications for Practice: The number of insured patients is increasing, but insured patients are paying more out of pocket for cancer care due to increased cost sharing. As a result, the number of underinsured cancer patients is increasing. Patients are faced with greater out-of-pocket health care costs, but treatment decision making is often made without consideration of these expenses. In our study, insured patients undergoing cancer treatment and seeking copayment assistance experienced considerable subjective financial burden, and they altered care to defray out-of-pocket expenses. Health insurance does not eliminate financial distress or health disparities among cancer patients. Financial distress or "financial toxicity" as a result of disease or treatment decisions might be considered analogous to physical toxicity and might be considered a relevant variable in guiding cancer management. Understanding how and among whom to best measure financial distress is critical to the design of future interventional studies.

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“…1,2 Insurers are passing along more of these costs to patients in the form of cost sharing. 3,4 As their out-of-pocket costs increase, 5 more insured patients are seeking financial assistance, 6 and as of 2011, approximately 20% of insured US adults were considered underinsured. 7 Little is known about how this growing population of underinsured patients copes with the financial burden of care or about the quality of care delivered to patients who apply for financial assistance.…”

Section: Introductionmentioning

confidence: 99%

Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer

Zullig

Peppercorn

Schrag

et al. 2013

JOP

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Purpose: The relationship between prescription medication adherence and financial burden is understudied, particularly in patients seeking financial assistance. Methods:We conducted a cross-sectional survey to examine the association between patient-reported prescription medication nonadherence and financial distress. Eligible patients were adults receiving treatment for solid malignancies enrolled between June 2010 and May 2011 from the HealthWell Foundation, a national copay assistance program. Nonadherence was defined as taking less medication than prescribed because of cost, not filling or partially filling a prescription because of cost, or taking medications prescribed for others. Logistic regression assessed associations between medication nonadherence and patient-reported, subjective financial distress.Results: Among 164 participants, 45% reported cost-related medication nonadherence. Four percent took medications prescribed for another person, 22% took less medication than prescribed, 25% filled a partial prescription, and 27% did not fill a prescription, all as a result of cost. Nonadherent participants were more likely than adherent participants to reduce spending on basics like food and clothing to pay for medication (P ϭ .01), and borrow and/or use credit to pay for medications (P Ͻ .01). In adjusted analyses, financial distress did not change odds of nonadherence (odds ratio [OR] ϭ 1.60; 95% CI, 0.71 to 3.60). Having a prescription drug plan (OR ϭ 0.27; 95% CI, 0.09 to 0.83) and older age (OR ϭ 0.48; 95% CI, 0.27 to 0.85) decreased odds of nonadherence. Being unemployed increased odds of nonadherence (OR ϭ 6.28; 95% CI, 1.60 to 24.64). Conclusions:Cost-related medication nonadherence was prevalent among cancer patients who sought financial assistance. Further investigation is needed to understand predictors of prescription medication adherence, a key component of quality care.

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A Copay Foundation Assistance Support Program for Patients Receiving Intravenous Cancer Therapy

Cited by 17 publications

References 7 publications

Identifying cancer patients who alter care or lifestyle due to treatment‐related financial distress

Identifying cancer patients who alter care or lifestyle due to treatment‐related financial distress

The Financial Toxicity of Cancer Treatment: A Pilot Study Assessing Out-of-Pocket Expenses and the Insured Cancer Patient's Experience

Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer

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