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Patient Assistance Programs

July 2016 | | ID: P8920F0A618EN
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Patience Assistance Programmes: Achieving Stakeholder Buy in

Patient Assistance Programmes (PAPs) help US patients financially and improve compliance, adherence and outcomes – what’s not to like? But many payers are sceptical, seeing PAPs as a cynical ploy by Pharma to buy market share and support drug prices.

This report explores the patient benefits, operational challenges and attitudes to, and the future for, PAPs through the eyes of payer and pharma experts. With the number of PAPs growing rapidly, the report uncovers what Pharma can do to positively engage all stakeholders.

Leading Pharma and Payer Experts Answer Key Questions:
  • Targeting support: Where should PAP money be targetedClinical benefits: What are the clinical benefits and clinician experience of PAPs?
  • Too complex: PAPs can be complex and challenging for patients and many do not engage – what role might technology play is streamlining this area?
  • Insurers role: To what extent are health insurers fuelling the need and growth of PAPs through their behaviour and policies?
  • Barriers: How might Pharma work with payers to develop PAP’s that meet both parties’ needs?
  • Obamacare: Why has the Patient Protection and Affordable Care Act not killed off the need for PAPs?
  • Patient Groups: What advantages could Pharma gain by closer collaboration with patient groups in the design and communication of PAPs?
KEY TOPICS EXPLORED
  • Drug price control proposals are vote winners and both Hilary Clinton and Donald Trump have indicated support. But is this really a likelihood?
  • Collaboration not confrontation is the way forward and sharing data from PAPs with payers could overcome resistance by demonstrating the benefits of compliance and better health outcomes.
  • Many companies now see PAPs as a key part of their commercial strategy and most products are now launched with a PAP
  • The free-of-charge PAPs are seen by patients and clinicians as part of pharmaceutical companies’ social responsibility activities and generate positive PR.
  • Online pharmacies could scupper some PAP initiatives. How concerned should you be?
EXPERT CONTRIBUTORS

This report represents a wide range of experience and views with contributions from:
  • Four US payers
  • Two pharmaceutical industry representatives
  • Nathan White, Global Practice Lead, Access Pathways and Outcomes, ApotheCom, a medical communications agency.
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1.EXECUTIVE SUMMARY

2.RESEARCH OBJECTIVES AND METHODOLOGY

3.PATIENT ASSISTANCE PROGRAMS: AN OVERVIEW

3.1.Key findings
3.2.What are patient assistance programs?
3.3.‘True’ PAPs provide free drugs to those who genuinely cannot afford them
3.4.Financial assistance schemes provide mechanisms for patients to receive
3.5.products at a discount
3.6.Coupons and co-pay assistance provide instant discounts at the point of purchase
3.7.Free trials and samples are beneficial for patients, physicians, and pharma companies
3.8.Rebates are less commonly used and not generally favored by industry or payers
3.9.Why are PAPs needed?
3.10.PAPs for chronic diseases and specialty products are seen as more valuable
3.11.PAPs deliver a range of benefits
3.12.PAPs are viewed negatively by many, particularly payers
3.13.The administrative burden associated with PAPs can be a drawback

4.INDUSTRY PERCEPTIONS OF PAPS

4.1.Key findings
4.2.There are a variety of reasons why pharma companies implement PAPs
4.3.Patient affordability is the major driver for PAPs
4.4.PAPs enable physicians to gain experience with products
4.5.PAPs are also driven by commercial needs
4.6.Industry views payers’ negative views of PAPs as somewhat unjustified
4.7.Insurers are seen as driving a need for PAPs
4.8.Working with payers to demonstrate PAPs’ benefits could drive greater acceptance

5.PAYERS’ PERCEPTIONS OF PAPS

5.1.Key findings
5.2.Payers have traditionally seen PAPs in a negative light
5.3.Payers see high pharmaceutical prices as the main driver for PAPs
5.4.Payers believe that pharma uses PAPs to remain competitive
5.5.Payers recognize PAPs deliver benefits to patients in financial need
5.6.Engaging with payers may help change perceptions of PAPs

6.FUTURE EVOLUTION OF PAPS

6.1.Key findings
6.2.PAPs will continue to be used but will evolve
6.3.The payers believe a revision of pharmaceutical pricing could reduce reliance on PAPs
6.4.Changes in insurance coverage may alter eligibility criteria
6.5.Case study: Gilead restricts enrollment in its PAP but other companiesare seen as unlikely to follow suit
6.6.Industry does not expect that legislation will be enacted to restrict PAPs
6.7.Technology will affect the way PAPs are conducted
6.8.Mail order pharmacy could become a hurdle for PAPs
6.9.Engaging with payers to ensure PAPs meet their needs may overcome resistance
6.10.Using PAPs to generate data would be valuable for all stakeholders
6.11.Patient assistance programs – SWOT analysis


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