Patient Assistance Program Improves Outcomes for Low-Income RA Patients

Oftentimes treatment is inadequate due to issues with access to care or medication costs for uninsured patients with rheumatic disease. However, according to an abstract presented at the 2017 ACR/ARHP Annual Meeting, a patient assistance program (PAP) and dedicated health care team within a community clinic setting can benefit low-income patients with accessing treatment and high cost biologics.

According to the poster, on average, medication costs average roughly $1659 per patient per 10 weeks of treatment, and although pharmaceutical companies have created PAPs to assist with patient care, the process of getting assistance is resource intensive due to eligibility requirements that vary across these foundations. For this study, researchers sought to understand the costs associated with care given within a community health clinic population.

The researchers developed a clinical team to aid patients who needed assistance for high-cost biologics, and the patients were then followed for roughly a year. The researchers observed successful PAP approvals and stratified their analysis based on a diagnosis of rheumatoid arthritis (RA) or other autoimmune diseases. Additionally, based off their observations, the researchers were able to catalogue reasons why patients were unable to renew enrollment.

The results of the study demonstrated a 94% PAP success rate for patients with an identified need. For patients with RA, a 93% success rate was reported. Patients with other autoimmune diseases also reported higher success rates. The researchers noted that PAP denial was often due to inadequate income documentation, and delay was associated with Medicaid and Medicare eligibility.

The analysis of the patients in the study also demonstrated a 68% renewal success rate. The reasons for a lack of renewal were because of newly acquired health insurance, personal choice, insufficient income documentation, and enrollment in Medicare.

The overall savings for the observed patient population was estimated to be roughly $1.2 million per year.

“In conclusion, investing resources to support individuals with limited resources in securing of assistance is a successful endeavor,” concluded the authors.

—Julie Gould