Use of Charity Assistance to Pay for Novel Oral Anticancer Agents

Key Points

  • Charity assistance was used by 36% of patients, including 47% of those aged ≥ 65 years.
  • Charity sources accounted for 4% of total drug costs and 64% of out-of-pocket expenditures.

In a study reported in the Journal of Oncology Practice, Olszewski et al found that 36% of patients receiving novel oral anticancer agents in a Rhode Island academic research center received charity assistance to pay for treatment, including 47% of patients aged ≥ 65 years.

Study Details

The study involved data from a specialty pharmacy affiliated with Rhode Island Hospital, Providence, including 1,557 prescriptions for 211 patients between January 2014 and March 2017. Patients had a median age of 70 years, 61% were male, and 83% were white. Insurance coverage was Medicare for 66% of patients, commercial/employer coverage for 17%, and Medicaid for 14%; 3% had no coverage.

Charity Assistance

Overall, 36% of patients received charity assistance to pay for prescribed agents, including 47% of patients aged ≥ 65 years. Charity sources accounted for 4% of total drug costs and 64% of out-of-pocket expenditures. The proportion of patients receiving charity financial assistance ranged from 7% when upfront out-of-pocket requirement was < $100, to 67% when the upfront requirement was > $1,000. For patients with out-of-pocket requirements exceeding $1,000, median direct cash contribution was $0, due to extensive use of charity assistance. Upfront charity assistance was associated with a longer time to filling first prescription (median = 9 vs 7 days, P =.011) and longer overall duration of therapy (median = 261 vs 134 days, P = .014).

The investigators concluded, “These findings indicate that high out-of-pocket burden for expensive novel oral anticancer drugs leads to widespread use of charity support in the United States, and that a significant financial barrier disparately affects older Medicare beneficiaries.”

The study was supported by grants from the American Society of Hematology, American Cancer Society, and Agency for Healthcare Research and Quality.

Adam J. Olszewski, MD, of Rhode Island Hospital, is the corresponding author for the Journal of Oncology Practice article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.




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