Situation
Healthcare systems across the globe face a similar core set of challenges. Chronic, non-communicable disease rates are increasing, and the medications needed to treat those diseases are often specialized, innovative medicines. The nature of such treatments means that they can often be more costly than non-specialized medicines, straining healthcare system budgets and leaving patients responsible for more of the cost. This issue is particularly prominent in low- and middle-income countries (LMICs). Knowing many patients won’t be able to afford a full course of these medications, doctors often have no choice but to stop prescribing what could otherwise be useful — potentially life-saving — treatment. Patients are then faced with the difficult option of using less than optimal medications, or trying, often unsuccessfully, to cover the cost of the specialized treatment on their own.
To address this, a multinational pharmaceutical company wanted to initiate a global Patient Support Program (PSP) platform to help overcome the financial difficulties patients face around the world – specifically patients living with select cancers and gastrointestinal diseases.
Solution
After a thorough analysis of the local market landscape using Access Prioritization Tool (APT), countries with the greatest need and in regions where the company was best positioned to support were prioritized for the PSP. The program currently runs across 10+ countries throughout Africa, Asia, Europe, and the Middle East and North Africa region.
While the overarching challenges, outlined above, in each part of the world are similar, the specific situation in each country is unique. This is why access programs are difficult to design. They require flexibility and a willingness to customize access strategies in each individual country based on their unique circumstances.
Taking each country’s unique needs into consideration, as well as the specific consideration for each program supported medication, Axios designed a novel, sustainable access strategy that improves patient’s ability to pay for treatment by sharing it’s cost among multiple parties.
The specific approach varied by country, but all models were designed to be sustainable for the patient, company and other parties involved:
Affordability-based: Patients whose physician prescribes one of the drugs are asked to pay only what they can afford, and the remainder of the treatment cost is covered by the manufacturer and potentially other parties. To determine how much help a patient needs, Axios utilizes its validated Patient Financial Eligibility Tool (PFET). Unlike other tools, PFET is customized to the local country context, providing a comprehensive financial assessment that considers not just the patient’s income but also their standard of living and assets. Through this approach, the pharmaceutical company is able to reach new population segments (with less ability to purchase), thus creating incremental revenues.
Co-pay support: For patients who are partially reimbursed, some still struggle to cover the non-reimbursed co-pay for their medication. By supporting these patients by covering their co-pay via voucher, they are able to complete their full course of treatment as prescribed.
Short-term financing: Many patients don’t have the liquidity to pay for the medication cost up front, even those that may be reimbursed. This doesn’t only deplete a patient’s savings, but it also robs them of the health benefits achieved through completing a full course of medication. They may be waiting for reimbursement or be able to pay in smaller increments. By offering a credit line, patients are able to access treatment immediately, and repay the amount once the funds become available.
In addition with help affording their treatment, patients also received ongoing, personalized support from Axios’ program team to make sure they were able to adhere to their treatment for the long run. As part of their role managing the program, Axios works closely with treating physicians and pharmacists and handles all drug logistics needs.
Results
Unlike bonus schemes (buy X, get Y free), the sustainable models described above enable patients to complete their full course of treatment even if they cannot afford to pay for it in full. This helps them get the most medical benefit out of their treatment. In return, it enables the manufacturer a sustainable growth in emerging markets by reaching a larger number of patients, rather than leaving behind those who cannot afford even discounted prices. Having benefited many patients who had little hope to recover, the program now aims to include other innovative, specialty care medicines. Results include:
- Thousands of patients currently enrolled
- Extended duration of treatment
- High physician acceptability
- Financial sustainability for patients and companies
