Perspectives focus on copay assistance, patient navigation and digital therapeutics.
A new Survivor Views survey from the American Cancer Society Cancer Action Network (ACS CAN) shows that while copay assistance programs can help cancer patients afford the medications they need, some aren’t able to apply them to their health insurance deductible or other out-of-pocket requirements, which can create a barrier to care.
Fielded May 16-26, 2022, the latest survey explores cancer patients’ and survivors’ experiences and perspectives on copay assistance, patient navigation, and digital therapeutics. The survey was conducted among 1,241 patients and survivors nationwide diagnosed with or treated for cancer in the last seven years, with another 1,370 interviews conducted among traditionally underrepresented demographic groups to allow for in-depth statistical analysis.
Key findings associated with cancer care affordability, specifically copay assistance programs, showed an overwhelming majority of respondents (83%) who applied to a copay assistance program and were accepted said the assistance enabled them to get medication they otherwise could not afford. However, more than a quarter (27%) of respondents who enrolled in a copay assistance program reported that the assistance they received was not applied to their health insurance deductible or other out-of-pocket cost requirements.
Sponsored by an individual pharmaceutical manufacturer or an independent foundation, copay assistance programs are offered to people with limited incomes or who have a high medical need. However, insurers are using copay accumulator adjustment programs that prevent counting copay assistance toward an individual’s health insurance deductible or maximum out-of-pocket limit, making it harder for patients to afford medically necessary prescription drugs.
The survey also found that one-fifth of all survey respondents reported having skipped or delayed taking a prescribed medication due to cost, with lower income (44%), Asian and Pacific Islander (40%), Black (44%), and Hispanic (58%) patients and survivors reported significantly higher rates of missed medication, underscoring the need for legislation requiring insurers to count all payments made by patients -- either directly or on their behalf -- toward their overall out-of-pocket maximum payment or deductible. ACS CAN is currently engaged in active campaigns on this issue in four states and will be supporting legislation in many more states in 2023.
Just over half of survey respondents have encountered someone fulfilling the role of a patient navigator, though definitions and tasks associated with the role vary. Clinical staff such as nurses, nurse practitioners, physician assistants, and nurse navigators are most often associated with the role of patient navigator. A strong majority (79%) agree that having a single contact for the issues addressed by patient navigators, such as offering emotional support, scheduling medical appointments, and providing transportation assistance are very important for cancer patients.
Additional findings include a majority of survey respondents (63%) reporting they would be likely to use digital therapeutics -- tools that deliver evidence-based medical interventions to patients via software programs to prevent, manage or treat diseases -- prescribed by their physician. However, a quarter are unsure about using them, with concerns including clarity about the benefits, associated costs, and privacy.
ACS CAN developed Survivor Views in 2019 to better understand the perspectives and experiences of cancer patients and survivors. A panel consisting of cancer patients and survivors participate in a series of surveys and provide important insights to support ACS CAN’s advocacy work at all levels of government.
For more information and to view detailed survey findings, visit Survivor Views: Copay Assistance and Patient Navigation | American Cancer Society Cancer Action Network (fightcancer.org).