Addressing Pain Control in Low-Income Cancer Patients: One Hospital's Innovative Pilot Program Finds Pharmaceutical Patient Assistance Programs Lacking

2005 ◽  
Vol 20 (6) ◽  
pp. 36-39
Author(s):  
Etienne Phipps ◽  
Judith Quinn ◽  
Nora Madison-Thompson ◽  
Sherry Pomerantz ◽  
Joann Ackler ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Low Income ◽  
Pain Control ◽  
Pilot Program ◽  
Assistance Programs ◽  
Patient Assistance

A medication acquisition program to facilitate access to nonstandard targeted oncologic therapies.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13505-e13505
Author(s):  
Vicki Doctor ◽  
Maurie Markman ◽  
Ankur Rasik Parikh ◽  
Bellinda Conte
Keyword(s):  
Cancer Patients ◽  
Targeted Therapies ◽  
Insurance Coverage ◽  
Standard Of Care ◽  
Consecutive Series ◽  
Precision Oncology ◽  
Tumor Type ◽  
Assistance Programs ◽  
Off Label ◽  
Patient Assistance

e13505 Background: Precision oncology provides targeted approaches to cancer diagnosis and treatment, but also carries significant risks to reimbursement and patient access. A recent survey found that up to 60% of authorization denials are due to the therapy being off-label and experimental. The Cancer Treatment Centers of America's Medication Acquisition Program (CTCA-MAP) was initiated in October 2015 with the goal of helping patients successfully navigate a medication acquisition process following prior authorization denials for off-label therapy. Methods: A consecutive series of cancer patients who were non-responsive to standard-of-care, and for whom off-label targeted therapies have been matched to a potentially actionable genetic or molecular variant were enrolled into CTCA-MAP following the denial of payer preauthorization. The CTCA-MAP appeals payer denials, and simultaneously coordinates applications to patient assistance programs. Each payer appeal is customized to the patient's disease profile and unique tumor genomics and is based on any available evidence supporting the therapy’s use and safety in the patient’s tumor type. Results: A total of 825 patients (338 males and 487 females; median age 57 years) were enrolled into the program from October 2015 to October 2020. The most common tumor types were breast (n = 157), colorectal (n = 96), pancreas (n = 72), lung (n = 68), ovarian (n = 35) and prostate (n = 35). 682 (82.7%) patients were able to access therapy through patient assistance programs (n = 548), overturned payer appeals (n = 133) or conversion from patient assistance to insurance (n = 1) within a median of 16 days from the date of program referral. Only 5 (0.6%) patients were unable to access therapy through payer appeals or philanthropic programs. The remaining 138 (16.7%) patients could not complete the program due to disease progression or death. The overturned payer appeals led to insurance coverage for an estimated USD 7.95 million in drugs (calculated as the multiplication of drug cost per cycle and the number of cycles received). Conclusions: The CTCA-MAP provides a mechanism through which cancer patients with potentially actionable genetic variants can acquire access to existing off-label targeted therapies when standard-of-care is no longer effective, or when they are ineligible for a clinical trial. This program's outcomes to date demonstrate a need for a concerted advocacy effort to increase accessibility for cancer patients to these innovative targeted therapies.

scholarly journals Utilization of Pharmaceutical Patient and Prescription Assistance Programs via a Pharmacy Department Patient Assistance Program for Indigent Cancer Patients

2016 ◽  
Vol 51 (7) ◽  
pp. 572-576 ◽  
Author(s):  
Limin Gao ◽  
Jivin Joseph ◽  
Marcelle Santoro-Levy ◽  
Alan S. Multz ◽  
Vladimir K. Gotlieb
Keyword(s):  
Cancer Patients ◽  
Assistance Program ◽  
Assistance Programs ◽  
Pharmacy Department ◽  
Patient Assistance

scholarly journals Financial assistance programs for cancer patients

2021 ◽  
Vol 3 (1) ◽  
pp. 119-123
Author(s):  
Steven S. Coughlin ◽  
◽  
Lorraine T. Dean ◽  
Jorge E. Cortes ◽  
◽  
...  
Keyword(s):  
Cancer Patients ◽  
Low Income ◽  
Financial Distress ◽  
Well Being ◽  
Small Sample ◽  
Financial Assistance ◽  
Sample Sizes ◽  
Or Education ◽  
Pilot Studies ◽  
Assistance Programs

Background： The high costs of oncology care can lead to financial stress and have deleterious effects on the well-being of patients and their families. However, only a handful of financial assistance programs for cancer patients have been implemented and evaluated to date. Recent findings： Key features of reported programs include instrumental support through financial navigation or education for patients, and financial or charitable support for healthcare costs. Only one of the programs successfully reduced actual out-of-pocket costs for patients, though others were associated with psychosocial benefits or increased knowledge of financial resources. Four of the 5 programs evaluated to date were pilot studies with small sample sizes, and most lack control groups for comparison. Conclusions. Additional studies are needed that include larger sample sizes and with comparison groups of cancer patients in order to determine whether the counseling and navigator programs are effective in addressing financial distress in this patient population. Of particular interest are programs designed for low-income patients and those who lack health care insurance. Financial assistance programs that implement solutions at different levels of the healthcare system (individual patients, providers, healthcare institutions) are more likely to be effective. Multi-level interventions are needed that address the systems in which patients access care, the actual costs of services and drugs, and the individual needs of patients in order to reduce financial hardship for cancer patients.

scholarly journals Racial, Gender, and Age Dynamics in Michigan’s Urban and Rural Farmers Markets: Reducing Food Insecurity, and the Impacts of a Pandemic

2021 ◽  
pp. 000276422110133
Author(s):  
Dorceta E. Taylor ◽  
Alliyah Lusuegro ◽  
Victoria Loong ◽  
Alexis Cambridge ◽  
Claire Nichols ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Food Assistance ◽  
People Of Color ◽  
Farmers Markets ◽  
Farmers Market ◽  
Assistance Programs ◽  
Nutrition Assistance ◽  
Nutrition Assistance Programs ◽  
Number Of Customers

In recent decades, the number of farmer’s markets has increased dramatically across the country. Though farmers markets have been described as White spaces, they can play important roles in reducing food insecurity. This is particularly true in Michigan where farmer’s markets were crucial collaborators in pioneering programs such as Double-Up Food Bucks that help low-income residents and people of color gain access to fresh, healthy, locally grown food. This article examines the questions: (1) What are the demographic characteristics of the farmers market managers, vendors, and customers and how do these influence market activities? (2) To what extent do farmers markets participate in programs aimed at reducing food insecurity? (3) To what extent do farmers markets serve low-income residents and people of color? and (4) How has the Coronavirus Pandemic (COVID-19) affected the operations of farmers markets. This article discusses the findings of a 2020 study that examined the extent to which Michigan’s farmer’s markets served low-income customers and people of color and participated in food assistance programs. The study examined 79 farmers markets and found that 87.3% of the farmer’s market managers are White. On average, roughly 79% of the vendors of the markets are White and almost 18% are people of color. Most of the vendors in the markets participate in nutrition assistance programs. Market managers estimate that about 76% of their customers are White and about 23% are people of color. Farmers markets operated by people of color attract higher numbers of customers and vendors of color than those operated White market managers. Almost half of the farmer’s markets started operations later than usual in 2020 because of the pandemic. More than a third of the markets reported that their funding declined during the pandemic. Moreover, the number of vendors declined at two thirds of the markets and the number of customers dipped at more than 40% of the markets. On the other hand, the number of people requesting food assistance during the pandemic increased in more than half of the markets.

scholarly journals Use of Formal and Informal Food Resources by Food Insecure Families in Lima, Peru: A Mixed-Methods Analysis

2021 ◽  
Author(s):  
J. D. Brewer ◽  
M. P. Santos ◽  
M. A. Lopez ◽  
V. A. Paz-Soldan ◽  
M. P. Chaparro
Keyword(s):  
Mixed Methods ◽  
Food Insecurity ◽  
Low Income ◽  
Food Resources ◽  
Food Assistance Programs ◽  
Assistance Programs ◽  
Food Security Status ◽  
Financial Need ◽  
June July ◽  
Food Insecure Households

AbstractThe goal of this study was to measure food insecurity among families with children in a low-income district of Lima, Peru and to identify the formal and informal food resources available to them that may affect their food security status. In June-July 2019, we collected data from 329 randomly selected households in Villa El Salvador (Lima, Peru). Following a mixed methods approach, we found that the percentage of households using food assistance programs (FAPs) increased with increasing levels of food insecurity, but two FAPs were heavily used by households regardless of food (in)security. The main reasons for using FAPs included financial need, already being signed up in the program, and believing that the food was of nutritional value; the main reasons for non-use were finding the program unnecessary, dislike or poor perceived quality of the food, and not being able to sign up for the program. Similarly, informal food resources, such as buying food on credit or receiving food from someone outside the household, were incrementally used with increased levels of food insecurity. Our study clarifies the relationship between level of household food insecurity and FAP use – FAPs more commonly used by food insecure households were used because of financial need, whereas the FAPs most commonly used by food secure households were those with automatic enrollment. At a programmatic level, our research highlights the need for making nutritious and preferred foods available in FAPs and standardizing the application of enrollment criteria.

Patient Assistance Programs: Information Is Not Our Enemy

2009 ◽  
Vol 28 (3) ◽  
pp. 843-844 ◽  
Author(s):  
Niteesh K. Choudhry ◽  
Joy L. Lee ◽  
Jessica Agnew-Blais ◽  
Colleen Corcoran ◽  
William H. Shrank
Keyword(s):  
Assistance Programs ◽  
Patient Assistance

scholarly journals A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Intensity Difference ◽  
Front Line ◽  
Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

PhRMA’s Patient Assistance Programs

2009 ◽  
Vol 28 (4) ◽  
pp. 1227-1227
Author(s):  
Kathryn Saenz Duke
Keyword(s):  
Assistance Programs ◽  
Patient Assistance

Dynamics of affordability and immigration in the Canadian housing market

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vikkram Singh
Keyword(s):  
Low Income ◽  
Negative Impact ◽  
Policy Formulation ◽  
Housing Affordability ◽  
Immigrant Integration ◽  
Full Time ◽  
Content Type ◽  
Assistance Programs ◽  
Essential Contribution ◽  
The Impact

Purpose This study aims to make two major contributions. First, given the literature gap in housing unaffordability for different immigrant groups in Canada, it makes an essential contribution to the literature. To the best of the knowledge, this study is the first study of its kind to examine housing unaffordability by examining different immigrant groups. Second, differences in unaffordability can help understand the decline in welfare, as it can have financial implications and a negative impact on health outcomes. Third, this study’s findings are valuable for policy formulation to improve immigrant integration and ease the housing unaffordability crisis. Design/methodology/approach This study examines the determinants of housing affordability to investigate differences among various immigrant groups in Canada. A bivariate logit model using public microdata from the Canadian census estimates the determinants of moderate and severe unaffordability. Additionally, the separation of tenants and owners provides insights into the dynamics of unaffordability. The results show significant differences between immigrant groups with higher levels of unaffordability among Asian immigrants. The insights can help devise and implement housing assistance programs to address the challenges arising from the post-COVID-19 pandemic phase. Findings The results indicate that unaffordability declines with increasing age, education and full-time employment. Gender dynamics are evident, with women faring worse than men regarding the likelihood of extreme housing unaffordability. Households face a greater likelihood of unaffordability in more populous provinces and larger census metropolitan areas that struggle with the high cost of living, racial disparities and low income. Immigrants, especially from Asia, Africa and the Middle East, continue to struggle with chronic and severe unaffordability issues. The impact is much more severe for those renting, exemplifying the strain it is taking on the financial health of recent immigrants. Originality/value Given the literature gap in housing unaffordability for different immigrant groups in Canada, it makes an essential contribution to the literature. To the best of the knowledge, this study is the first study of its kind to examine housing unaffordability by examining different immigrant groups.

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