Impact of Co-pay Assistance on Patient, Clinical, and Economic Outcomes

Author(s): Krupa D. Parekh, PharmD, MPH, William B. Wong, PharmD, MS, Leah L. Zullig, PhD, MPH
Source: The American Journal of Managed Care, May 2022, Volume 28, Issue 5

Nathan Walcker's Thoughts

Here we see a review of literature assessing the impact of patient assistance programs on outcomes broadly in cancer care. While indirect links may be drawn between the prevalence of financial toxicities and outcomes, adherence, etc., additional research studies are needed to more clearly demonstrate the tangible impact of these programs to support future investments from stakeholders.



Patient assistance programs (eg, co-pay assistance) may reduce patients’ out-of-pocket costs for prescription medicines, providing financial assistance to access medicines for reduced or no cost. A literature review to identify peer-reviewed articles on studies evaluating the impact of co-pay assistance on clinical, patient, and economic outcomes was conducted.


A literature review was conducted by searching Embase and MEDLINE.


The population of interest was patients who had received co-pay assistance; the intervention was co-pay assistance; comparator was no co-pay assistance; and outcomes were treatment adherence, compliance, discontinuation, interruption, barriers to adherence, and specific therapeutic outcomes. Articles from the United States published between January 2015 and June 2021 were included.


A total of 1249 initial articles were identified, of which 19 published articles representing 12 studies were included. Most studies were retrospective claims analyses (n = 10); there was also 1 randomized controlled trial and 1 prospective and observational study. One article assessed the association between co-pay assistance and patient-reported outcomes, 7 explored the relationship between co-pay assistance and clinical outcomes, and 6 assessed the impact of policy/program changes on co-pay assistance. Co-pay assistance was associated with improved treatment persistence/adherence across various diseases, with limited indirect evidence of this translating into clinical outcomes improvements. Lack of long-term outcomes and uncertainty around program sustainment from co-pay assistance programs are limitations.


Limited evidence suggests a potential link between co-pay assistance and clinical outcomes; future research addressing study design challenges in measuring the effects of co-pay assistance is needed.

Read Full Article Here

Author Affiliations

Genentech, Inc (KDP, WBW), South San Francisco, CA; Department of Population Health Sciences, Duke University School of Medicine (LLZ), Durham, NC; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System (LLZ), Durham, NC.

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