The financial burden of PARP inhibitors on patients, payors, and financial assistance programs: Who bears the cost?

Poly(ADP-ribose) polymerase (PARP) inhibitors are expensive and their use is expanding. We aimed to evaluate cost sharing patterns between patients, payors, and financial assistance programs. We identified ovarian cancer patients prescribed a PARP inhibitor from 5/2015–9/2019 using our pharmacy data...

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Bibliographic Details
Published in:Gynecologic oncology 2021-03, Vol.160 (3), p.800-804
Main Authors: Goldsberry, Whitney N., Summerlin, Sarah S., Guyton, Allison, Caddell, Brittani, Huh, Warner K., Kim, Kenneth H., Liang, Margaret I.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Drug cost
Female
Financial assistance
Health Expenditures - standards
Humans
Middle Aged
Out of pocket cost
Ovarian cancer
PARP inhibitor
Poly(ADP-ribose) Polymerase Inhibitors - economics
Young Adult
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Summary:Poly(ADP-ribose) polymerase (PARP) inhibitors are expensive and their use is expanding. We aimed to evaluate cost sharing patterns between patients, payors, and financial assistance programs. We identified ovarian cancer patients prescribed a PARP inhibitor from 5/2015–9/2019 using our pharmacy database. Cost information was collected for patients who filled their prescription at our specialty pharmacy. We calculated descriptive statistics for monthly PARP inhibitor costs for patients, payors, and financial assistance programs. We used Wilcoxon rank sum tests to evaluate monthly costs based on insurance characteristics. Seventy-six patients filled 94 different PARP inhibitor prescriptions with 42 (45%) prescriptions obtained using any type of financial assistance program. We analyzed 232 prescription months for the 41 prescriptions with available cost data. This included 18 (44%) prescriptions for rucaparib, 18 (44%) for niraparib, and 5 (12%) for olaparib. The total monthly drug cost was average $12,422 and median $13,700. The monthly out-of-pocket (OOP) cost for patients was average $46 and median $0 (IQR $0–4). Payors had the highest monthly costs with average $12,019 and median $13,662 (IQR $9914-14,709). Financial assistance programs contributed average $358 and median $0 per month (IQR $0–150). Patients with public (p
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2020.12.039