A multistakeholder approach to patient assistance programs was the topic of discussion at ACCC's first annual ICLIO meeting in Philadelphia.
Oncologists are increasingly aware of the hardships patients face as they choose newer oncolytic agents that promise better outcomes. The financial toxicity of healthcare, particularly in oncology, is not lost on anyone and drug companies have renewed their efforts with patient assistance programs, ensuring that physicians—in addition to patient support groups—are aware of the financial resources that patients can turn to. “We work extensively to provide clarity around our programs to clinicians,” shared Frank Marra, executive director, Patient Affordability and Executive Services at Bristol Myers Squibb.
Marra was part of a panel discussion at the first national meeting of the Institute for Clinical Immuno-Oncology, an initiative of the Association of Community Cancer Centers, held October 2, 2015, in Philadelphia. The panel followed a presentation by Linda House, RN, BSN, MSM, president, Cancer Support Community (CSC). According to House, the patients open up to CSC more than they do with their oncologists. “We try to work on psychosocial aspects of the patient’s care,” she said. In their 8000 cancer patient registry, CSC has observed that 75% of cancer patients follow their clinician’s advice when making health decisions. So with respect to newer, more expensive immuno-oncology agents, the quality of patient care is closely associated with reimbursement. And to be able to afford this expensive care, patients and their families sacrifice vacations, social events, and skimp on groceries, House said.
“Many live with chronic toxicities, and need follow-up care; 36% do not return to work.” Mental health conditions are an important side-effect associated with their suffering and “depression in cancer patients is estimated to cost about $8400 per patient,” said House, adding that the pharmaceutical industry is actively partnering with organizations like CSC to understand the needs of patients and to provide improved support. “We have 1-800 helplines at CSC, with mental health counselors on call,” and CSC’s partnership with Onyx Pharmaceuticals allows their support line to transfer callers to CSC’s helpline.
During the subsequent panel, Delali Attiogbe, site manager for BioOncology Managed Markets, Genentech, said that her company understands that patients do hold financial conversations with their treating physician and so her company is ensuring physician awareness on patient support programs. “We are also partnering with groups like CSC, arranging warm transfers of patients. There’s are dedicated groups within the company to help the process,” said Attiogbe.
Charles Lynch, program coordinator of Oncology Medical Assistance Program at Yale-New Haven Hospital, said “We have a support system at Yale that various health service providers are involved in, including clinicians, nurses, and social workers.” After the treatment clinic works out a treatment plan, his department calculates the patient’s out-of-pocket expenses and also evaluates the available alternatives on drug lists, Lynch explained. “We explore PAN [Patient Access Network] and PAF [Patient Advocate Foundation] foundation grants and copay cards…all the information is assessed to support care.”
When asked if the newer immuno-oncology agents have created unique challenges for patient assistance programs, Marra said that while similar challenges have persisted over the years, newer products have only amplified the problem. “We work extensively to provide clarity around our programs to clinicians and we are striving to enroll every patient in the program. Each patient is different and the program tries to adapt around their needs,” said Marra.