Pharmacy Patient Assistance Program Reduces Financial Toxicity

Researchers assessed the implementation of specialized financial accounting and pharmacy technician personnel to provide assistance to patients receiving high-cost cancer chemotherapy and found that this was a benefit for patients, reduced the financial toxicity, and had a “positive budgetary impact,” according to the researchers.

The 340B drug pricing program was created by Congress in 1992 to provide certain health care providers significant discounts on prescription drugs. It allows eligible hospitals, clinics, pharmacies, nursing homes, home healthcare agencies, hospices, dialysis centers and long-term acute care facilities (among others) to replenish prescription inventories at prices far below market rates.

The results of the study were presented by Andrea Ledford, PharmD, MBA, BCOP, BCSCP, oncology pharmacy manager at the Orlando Health University of Florida Health Cancer Center, at HOPA’s 16th Annual Conference.

Between October 2015 and September 2016, researchers assessed a baseline cohort who were offered drug replacement only at the primary cancer center location. The copay program was initiated in October 2016 through October 2018 and expanded the number of onsite personnel, as well as expanded the program to three regional sites.

Patient financial benefit was assessed annually using actual drug cost or copy offset provided by the drug manufacturer. This only applied to injectable products administered in the infusion setting. The centralized copay assistance personnel collaborated with onsite personnel during the regional expansion, and hospital drug charges were reversed as patient benefit was received at each location.

The baseline primary center location realized $3,037,733 in drug replacement benefit with no regional site or copay benefit. During each year following implementation, the following drug replacement benefits costs were realized at the primary location:

  • 2016: $3,465,754
  • 2017: $4,310,177
  • 2018: $4,233,990

The following copay assistance costs were:

  • 2016: $349,933
  • 2017: $755,369
  • 2018: $807,171

In 2018, the three regional locations yielded $731,871, $897,986, and $707,426 in replacement benefit. The 2018 patient benefit divided by the total drug replacement expense yielded a financial ratio of 8.1% at the primary site and 7.7%, 6.5%, and 7.2% at the regional sites. The financial ratio of copay savings was 1.2%.

The additional personnel increased total patient benefit from $3,037,733 to $7,428,445 (P<0.0001) and copay benefit from $0 to $807,171 (P<0.0001).

“The payer mix and prescribing trends remained stable during this evaluation,” the authors noted. “The creation of a financial ratio for patient benefit compared [with] total actual pharmacy expense can be developed to assess program success using a range specific for each location.”


Ledford A, Laurazon R, Tavella-Bunca P, et al. Expansion of a pharmacy patient assistance program. Presented at HOPA 16th Annual Conference. March 11-14, 2020, Tampa, Florida.