MANUFACTURER-SPONSORED PATIENT ASSISTANCE PROGRAMS

To advocate that pharmaceutical manufacturers extend their patient assistance programs (PAPs) to serve the needs of both uninsured and underinsured patients, regardless of distribution channels; further,

To advocate expansion of PAPs to inpatient settings; further,

To advocate that pharmaceutical manufacturers and PAP administrators enhance the efficiency of PAPs by standardizing application criteria, processes, and forms; further,

To advocate that pharmaceutical manufacturers and PAP administrators enhance access to and visibility of PAPs to pharmacy personnel and other healthcare providers; further,

To encourage pharmacy personnel, other healthcare providers, and pharmaceutical manufacturers to work cooperatively to ensure PAPs include the essential elements of pharmacist patient care, are patient-centered, and are transparent; further,

To develop education for pharmacy personnel and other healthcare providers on the risks and benefits of PAPs.

Rationale

ASHP recognizes the value of patient assistance programs (PAPs) in improving continuity of care while controlling costs and advocates expanded use of these programs for uninsured and underinsured patients in ambulatory and inpatient care settings. Some organizations have demonstrated success in achieving the benefits of these programs through dedicated resources and a mastery of the many programs available. Simplification of these programs (similar eligibility criteria, a common data format) would reduce the resources required to participate and improve access and utilization. Other barriers for enrolling patients in PAPs include annual out-of-pocket spend requirements to re-enroll, confusing forms, and inability to renew in advance of new year. ASHP notes that while the number of PAPs in ambulatory care settings has increased, there has been little growth in programs for inpatients. Hospitals must then absorb the costs of patient care, which results in fewer resources in the overall healthcare system. ASHP believes that expansion of PAPs to indigent inpatients would significantly offset some of the costs to hospitals and ultimately improve care. In addition, interprofessional cooperation will be needed to support patients in accessing drug products when the PAP doesn’t cover the cost of the drug product due to high deductibles or co-pays. To ensure that these programs achieve their objectives, ASHP advocates that development of these programs ensure that they contain the elements of pharmacist patient care to enhance access to and visibility of PAPs.