The median and mean out-of-pocket costs for a 30-day supply of tafamidis were $1,909 and $3,082, respectively, before financial assistance. Insurance providers covered a mean of 89% of the total cost. Thirty percent of patients received copayment assistance from the manufacturer. Patients who qualified for financial assistance paid nothing.
The authors noted that, as the systems are set up today, copayment programs are essential for tafamidis to reach the hands of the very patients who need it.
“The most pertinent regulation to patients is that the assistance should be based on reasonable and consistent measures of financial need, requiring certain thresholds to be put in place under which patients may qualify for assistance,” wrote lead author Ahmad Masri, MD, MS, Oregon Health & Science University, and colleagues. “There are many elderly individuals who do not qualify for assistance based on these thresholds but have other preexisting competing financial commitments that prohibit them being able to afford the costly copayments. In addition to these eligibility stipulations, the funds in these nonprofit foundations are liable to run out. We have experienced periods during which programs have closed temporarily, causing tremendous uncertainty for patients.”
Masri et al. also wrote explained that great care was taken to ensure patients could afford the medication. “An integrated multidisciplinary amyloidosis program, a specialty pharmacy and a dedicated pharmacist” would all work with each individual patient as a part of that process.
The full analysis is available here.
Back in February, an analysis from Circulation noted that the price of tafamidis needed to be reduced by a whopping 92.6% for it to be accessible to the general public.
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