Patient perspectives and use of copayment assistance during the COVID-19 pandemic

BACKGROUND: Copay assistance programs provide financial assistance for patients to access medicines and may be one solution to addressing patient affordability, especial-ly because of additional financial hardships due to the COVID-19 pandemic. These pro-grams have been scrutinized by payers and policymakers, but there is little information on the patient perspective to inform these policy discussions.OBJECTIVE: To understand patients' perspec-tives and use of copay assistance during the COVID-19 pandemic.METHODS: A nationwide cross-sectional online descriptive patient survey was admin-istered to collect data from adult recent medication users and caregivers. Data on demographics, skipping/stopping medica-tions, current/past/future use of copay assistance, perceptions of copay assistance, and alternative actions taken if copay assistance was unavailable were collected. Descriptive analysis was conducted across the total sample, with subgroup analysis between those using and not using specialty pharmacies conducted on select measures. Analyses were conducted using STATA version 14.2.RESULTS: The final sample consisted of 1,001 adults aged 18 years or older. Twenty-eight percent of respondents reported currently or previously using copay assistance, with use higher among specialty pharmacy users vs non-specialty pharmacy users (46% vs 15%, P < 0.01). Copay assistance programs were viewed positively by most respondents (> 70%), with the proportion who viewed them "somewhat or more positively " during the COVID-19 pandemic growing significantly more among specialty pharmacy users than among non-specialty pharmacy users (53% vs 24%, P < 0.01). Respondents using copay assistance programs indicated they would take on more debt and cut back in other areas as alternatives to copay assistance, if unavailable. The alternative actions differed by specialty pharmacy use, with specialty pharmacy users reporting being more likely to use savings/retirement funds to help cover the cost (44% vs 22%, P < 0.01) or switch insur-ance plans (36% vs 22%, P = 0.03).CONCLUSIONS: Patients' positive perceptions of copay assistance programs have grown during the COVID-19 pandemic, and remov-ing access to these programs may result in further debt and/or loss of savings for patients, especially for those using specialty medicines. Future patient-centric research is warranted and should be central to informing future policy discussions on the regulation of copay assistance programs.