26th January, 2024
Table of Contents
Many patients, even if they can afford to cover the cost of medication, often face difficulty managing cash flows, especially during long-term treatment plans for chronic conditions. A systematic review of studies shows that when it comes to choosing between expenses, many individuals who suffer from chronic diseases prefer to cut down their expenses on treatments and medicines to save costs. A practical viewpoint shows us that this phenomenon, known as Cost-Related Non-adherence (CRN), is directly related to the rising costs of medication in conjunction with the overall increase in costs of living. Studies also show that many patients with chronic illnesses find it difficult to pay for treatment and medicines because they are already experiencing huge medical expenses for hospitalization, regular checkups, and laboratory testing, among other costs, including expenses related to their standards of living.
Failing to follow through and complete the treatment course because of financial concerns is a common yet high-risk challenge. While patients may not choose to stop taking medication altogether, many may resort to buying only a portion of the essential or more affordable medications.
When looking at the long-term implications of this situation, non-adherence to treatment leads to complications for stakeholders involved in the process of providing care and treatment. For patients, non-adherence can include the risk of developing larger, more complicated health issues and comorbidities down the road. For example, when a person with untreated diabetes develops chronic kidney disease, they may end up facing an infinitely more complicated condition. For healthcare providers it further complicates the treatment process, limiting the effectiveness of their course of treatment. Payers who bear the cost of treatment, such as insurers or the government, can face catastrophic outcomes when patient health and medical outcomes are not optimal. For the community at large, it can pose a threat to the outcome of treatment, lower the rate of success, and cause a functioning drug to lose its credibility. Also, specialized care and treatment resources, such as physicians, nurses, and hospitals, are already limited. Not adhering to prescribed treatment procedures reduces the effectiveness of medical care and patient well-being, contributing to the strain on physicians and hospitals, which are already overburdened.
On-Time Access to Treatment Helps Patients Receive Immediate Financial Support
Alongside the rapid development of technology and science, there has been a corresponding increase in the number of diseases and individuals suffering from chronic illnesses. If we just take cancer into account, according to data provided by the Centers for Disease Control and Prevention (CDC), in 2017, there were an estimated 18.1 million new cancer cases and 9.6 million cancer deaths worldwide. In 2020, there were an estimated 19.3 million new cancer cases and 10 million cancer deaths worldwide. In 2021, there were an estimated 19.9 million new cancer cases and 10.3 million cancer deaths worldwide, depicting a steady increase in the number of cases. This report from the National Cancer Institute shows that in the future, the number of cases alongside the cancer-attributable costs for medical services and oral prescription drugs are likely to steadily increase. While both these studies confirm that access to newer treatments and medicines and prevention made possible by pre-screening can reduce the number of cancer patients, affordability remains a bigger concern, especially in lower-middle-income countries.
Recognizing these gaps in treatment, the access experts at Axios International strategically use Axios proprietary scientific tools and real-world insights to design and implement affordable and sustainable access programs. This is why Patient Access Programs (PAPs) managed by Axios International are designed and implemented with sustainability at the core, enabling more patients to receive appropriate treatments, complete treatment courses, maximize adherence, prevent further complications and serious illnesses, and overall minimize the burden on hospitals, physicians, and healthcare providers.
Axios’ Proprietary Scientific Tool - PFET, Assesses The Financial Help A Patient Needs
The Patient Financial Eligibility Tool (PFET) is a revolutionary development in the field of access to healthcare. PFET, the proprietary tool developed by Axios International, assesses the support and help a patient requires to complete a full course of treatment using evidence-based, real-world data.
PFET has been successfully used to assess more than 23,000 patients in 30+ countries. In nine cases out of ten, patients agree to be assessed by PFET before enrolling in an Axios-partnered Patient Assistance Program (PAP). The accuracy of PFET’s assessment of a patient’s ability to pay has been verified and commended in the scientific publications Population Health Management and the Journal of Comparative Effectiveness Research.
One of the success stories of Axios-managed Patient Assistance Programs using PFET comes from Egypt, where the program was launched to provide On-Time Access to Treatment Solutions to patients of Oncology and Hematology. According to the study, a staggering 98% of patients did not have the means to pay for prescribed medication. Even if they had insurance, they did not have funds to pay until the reimbursements arrived. Most patients began receiving treatment and used up their savings and other liquid assets long before they could get reimbursed, leading to treatments being abandoned halfway with inefficient results.
The study also showed that due to their inability to pay for treatment, many patients neglected treatment after being diagnosed for up to three months prior to the program’s implementation. However, after enrolling in the Axios On-Time Access program, their inability to pay for treatment dropped from three months to just two days. The success of this program is evident in the fact that this number has now been reduced to an average of two days. The Egyptian public healthcare sector has expressed the wish further to support the development of the On-Time Access program to cover more areas of healthcare as well. Asia, Europe, and the Middle East are other regions with similar success rates.
The program's ability to ensure that patients receive ongoing care and adhere strictly to their full treatment regimens means that the medical outcomes for patients, after being assessed by PFET, are favorable.
Once patients’ financial eligibility assessment determining their ability to pay for the treatment is complete, the next step is to enroll the patient in a program that suits their situation the most.
To mitigate risks concerning patient data, Axios has put in place a strong compliance infrastructure in all its Access to Treatment solutions. All processes are aligned with the General Data Protection Regulations (GDPR). At the same time, strict data privacy controls and integrity measures are put in place for the collection, processing, usage, storage, and destruction of personal information.
Axios-managed PAPs provide equitably affordable access solutions to diagnosis and treatment and help patients overcome their financial barriers, including limited insurance coverage, overwhelming co-pay non-reimbursements, and more. The multistakeholder approach helps Axios design and implement numerous innovative financial methods given to patients as a stand-alone or bridging/ bundled solution, helping patients access treatment. Some of the Access to Treatment Solutions include fixed schemes, tiered cost-sharing, co-pay, on-time access to treatment (short-term financing), direct-to-institution, and many more.
Fixed Scheme support:
Under this program, patients are given a fixed offer per the agreement without undergoing a financial eligibility assessment.
Tiered Cost-Sharing support:
In this program, the affordability gap that the patient is not able to bear is shared among contributing parties such as charities, NGOs, insurers, governments, pharmaceutical companies, and other potential stakeholders. Sharing the cost decreases the burden on patients and financiers and contributes to increased success rates of treatments and sustainability of the Patient Access Programs. It differs from traditional fixed schemes since patients can pay what they can afford and continue receiving treatment.
Some patients have insurance but with a monthly co-payment amount where the average patient share is 10-30 percent of the monthly medication cost. Following the PFET assessment, Axios facilitates financial support to patients based on their identified needs by offering co-pay support by issuing co-pay vouchers to cover the patient’s share, following the assessment result and quantity of support required.
Compliance Benefit Scheme:
This program rewards the patient for their commitment to treatment adherence. For example, if they comply with month X, they will get month Y free of charge. This innovative approach encourages compliance and their journey toward maximized adherence.
On-Time Access To Treatment (Short-Term Financing) Support:
This program solution is offered as a value-added service, bundled with other innovative financial treatment programs to help patients overcome cash flow shortages while waiting for support in situations such as delayed insurance reimbursement.
Based on the individuals’ affordability needs, patients are eligible to receive this value-added service as an immediate treatment or medication support whereby a short-term credit facility is arranged on a zero-interest installment basis to cover the cost for their full course of treatment. Axios facilitates this program solution by working together with multiple stakeholders, such as financial institutions, patients, and pharmaceutical companies.
With this timely intervention, patients can overcome any unforeseeable delays in beginning or continuing their treatment, resulting in maximized adherence to treatment.
Since its inception in 1997, Axios International has transformed patients' lives everywhere with its patient-centric access solutions, which help those who need it most. Carrying on its legacy of supporting patients, Axios has designed and continues to implement innovative access programs in collaboration with broader healthcare stakeholders.
Today, thousands of patients benefit from this innovative and sustainable access to treatment solutions and programs managed by Axios. This success is apparent and proven by the measurable high success rates and the wholehearted and unbiased acceptance and benefits of the programs, services, and solutions by stakeholders and, most importantly, the patients.