Survey: Who Uses Patient Assistance Programs?
Patient assistance programs (PAPs) are programs run by pharmaceutical manufacturers to help patients afford expensive, brand-name medications.
PAPs have been around for decades. But who uses them, and how are people learning about them? In order to find out more about PAPs, GoodRx, in collaboration with RA Capital, surveyed nearly 200 people from April 29 through October 13, 2022 who had used or applied for a PAP.
Below we walk through the demographics of PAP users, how patients find out about PAPs, and some of the challenges patients face using PAPs.
PAP users are a relatively homogenous group
PAP users tended to be similar when it came to age, race, and insurance use. In our survey, nearly 70% of patients applying for and using PAPs identified as 65 or older. They also primarily identified as white (84%). The majority of respondents used Medicare as their insurance (59%), followed by employer-based insurance (18%) and no insurance (9%).
Even though 81% of people in the U.S. live in a city, city-dwellers only accounted for 17% of the PAP users in our study. The majority of people surveyed who had ever applied for or used a PAP were from suburban areas (54%) and rural areas (29%).
Healthcare providers are the leading referral source for PAPs
According to our survey, respondents first learned about PAPs primarily through two sources: a healthcare provider (50%) or a drug manufacturer’s website (30%). The remainder learned about PAPs in other ways, including via advertisements, sites like GoodRx, and social media.
Stakeholders should consider using social media and other modern communication technologies to spread awareness of PAPs, especially to the uninsured and underinsured. These groups are likely to have fewer chances to communicate with healthcare providers and are more likely to have trouble affording their medications.
PAPs are often used for chronic conditions
Patients often use PAPs to afford and stay on medication that would otherwise be too expensive — namely brand-name medications. Most respondents used PAPs to access medications to treat chronic conditions such as diabetes, arthritis (including psoriatic arthritis and rheumatoid arthritis), chronic obstructive pulmonary disorder (COPD), asthma, and migraine.
One thing is certainly clear: PAPs are an essential tool for helping patients get the medication they need. Many PAP users would need to forgo the medication their provider prescribed if they weren’t able to receive financial assistance. Of the respondents in our survey who had used a PAP before, over 75% would have been unlikely to fill the medication without the PAP.
Difficulties with using PAPs
While PAPs can be a very helpful resource for patients who manage conditions with expensive medication, they can sometimes be difficult to use. In fact, of the patients we surveyed who had used a PAP before, over one-quarter reported that the program was difficult to use. This could be due to difficulties in applying for a PAP, communicating with PAP administrators, receiving the medication from the PAP, or a combination of the above.
Unfortunately, many PAPs have strict eligibility requirements; if an individual does not meet the eligibility criteria for a given manufacturer’s program, they will be denied access. Based on our survey, the most common reasons for PAP applications being rejected were income eligibility requirements (many PAPs have maximum income requirements; the amount varies depending on the program) and insurance status requirements (some require an individual to have insurance; other programs, like Gilead’s Advancing Access program, are strictly for uninsured individuals).
Applying for a PAP
There are around 2,000 PAPs currently offered, spanning many different manufacturers and drugs. In general, the process of applying for and using PAPs tends to be consistent across all programs.
If you’re interested in whether a patient assistance program exists for your medication, look on the manufacturer website for PAP information (or look under “Savings Tips” on the GoodRx drug page). From there, you will likely be directed to fill out an eligibility screener or application, and receive more information if eligible.
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For those who are having difficulty affording medications but aren’t able to use PAPs, there are groups that can help, including HarborPath and Paying Till It Hurts.
Co-contributors: Lauren Chase
References
U.S. Census Bureau. (2021). Urban areas facts.
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