The financial burden of PARP inhibitors on patients, payors, and financial assistance programs: Who bears the cost?

Autor: Goldsberry WN; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America., Summerlin SS; School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America., Guyton A; Department of Pharmacy, University of Alabama at Birmingham, Birmingham, AL, United States of America., Caddell B; Department of Pharmacy, University of Alabama at Birmingham, Birmingham, AL, United States of America., Huh WK; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America., Kim KH; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America., Liang MI; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America. Electronic address: mliang@uabmc.edu.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2021 Mar; Vol. 160 (3), pp. 800-804. Date of Electronic Publication: 2021 Jan 04.
DOI: 10.1016/j.ygyno.2020.12.039
Abstrakt: Objectives: Poly(ADP-ribose) polymerase (PARP) inhibitors are expensive and their use is expanding. We aimed to evaluate cost sharing patterns between patients, payors, and financial assistance programs.
Methods: We identified ovarian cancer patients prescribed a PARP inhibitor from 5/2015-9/2019 using our pharmacy database. Cost information was collected for patients who filled their prescription at our specialty pharmacy. We calculated descriptive statistics for monthly PARP inhibitor costs for patients, payors, and financial assistance programs. We used Wilcoxon rank sum tests to evaluate monthly costs based on insurance characteristics.
Results: Seventy-six patients filled 94 different PARP inhibitor prescriptions with 42 (45%) prescriptions obtained using any type of financial assistance program. We analyzed 232 prescription months for the 41 prescriptions with available cost data. This included 18 (44%) prescriptions for rucaparib, 18 (44%) for niraparib, and 5 (12%) for olaparib. The total monthly drug cost was average $12,422 and median $13,700. The monthly out-of-pocket (OOP) cost for patients was average $46 and median $0 (IQR $0-4). Payors had the highest monthly costs with average $12,019 and median $13,662 (IQR $9914-14,709). Financial assistance programs contributed average $358 and median $0 per month (IQR $0-150). Patients with public (p<0.01) or Medicare insurance (p<0.01) had higher OOP costs than without.
Conclusions: OOP costs were generally low with 75% of patients paying <$5 per month. While limited by small sample size at a single institution, financial assistance programs appear to play a critical role to ensure access to PARP inhibitors as nearly 50% of patients utilized these programs.
Competing Interests: Declaration of Competing Interest WKH reports fees from Altum and LICOR and serves on the Data Safety Monitoring Board for Inovio, which are all outside the scope of this work. The other authors report no disclosures.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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