Impact of comorbidities on people with and without cancer early in the <scp>COVID</scp>‐19 pandemic: An observational study

Schwartz, Carolyn E.; Rapkin, Bruce D.

doi:10.1002/cam4.6212

Cited by 3 publications

(1 citation statement)

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“…This study used convenience sampling to concurrently recruit participants from the Rare Patient Voice (RPV) patient panels and the Hope for Hemophilia (HOPE) patient advocacy group. In previous studies, RPV patient panels have been used across multiple disease areas, [10][11][12] and in the present study they were included to survey patients across conditions that may be treated with specialty medications. The HOPE patient advocacy group was used primarily to survey patients with hemophilia, because there have been anecdotes of these patients being impacted by AFPs.…”

Section: Methodsmentioning

confidence: 99%

A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

Wong,

Yermilov,

Dalglish

et al. 2024

Preprint

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BackgroundAlternative funding programs (AFPs) seek to reduce plan sponsor costs by excluding specialty drugs from a beneficiary’s plan coverage and requiring patients to obtain medications through alternative sources (typically, the manufacturer’s patient assistance programs [PAPs]) via an AFP vendor as a third-party).ObjectiveTo describe patients’ experiences and medication access with AFPs, which have not been explored previously.MethodsA survey instrument consisting of optional single- and multiple-choice questions with branching logic was administered to patients recruited from an online patient panel and a patient advocacy group who had experience with AFPs. The survey assessed patients’ awareness of AFPs from their employers, experience with the PAP application process via the AFP vendor, timeliness of medication access (if granted), and/or the health impact of any delay in access. All analyses were descriptive and exploratory subgroup analyses were conducted by disease area and reported income levels.ResultsIn total, 227 patients were included in the final sample. Most patients (61%) first heard of the AFP as part of their health benefit when trying to obtain their medication. Up to 88% of patients reported being stressed owing to the medication coverage denial and the uncertainty of obtaining their medication. Over half of patients (54%) reported being uncomfortable with the benefits manager from the AFP vendor. On average, patients reported waiting to receive their medication for approximately 2 months (68.2 days); 24% reported the wait for the medication worsened their condition and 64% reported the wait led to stress and/or anxiety. Patients who indicated the wait time negatively affected them had considered a job change or left their job at a 3–5-fold higher rate than those who reported no impact from wait time. Patients with hemophilia and other bleeding disorders reported receiving their prescribed medication less often than patients with other conditions (63% vs 82%), while more patients with lower incomes (< $50,000 vs > $50,000) reported not receiving any medication (12% vs 5%).ConclusionsMost patients who obtain their specialty medicines via AFPs reported being uncomfortable with the process and experiencing treatment delays, which may have been linked to disease progression, worsened mental well-being and consideration of a job change. Employers should be aware of the potential downstream impacts on employee health, retention, and the employee–employer relationship when considering implementing an AFP into their health plan.Plain Language SummaryPatients who have used alternative funding programs (AFPs) to access their medication were surveyed to understand their experiences. We found that using AFPs may lead to delays in patients receiving their medication, which may lead to worsening of their disease and add to their stress/anxiety. Employers should be mindful that, because of AFPs, patients reported considering leaving their jobs to find a role with better insurance coverage.

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Section: Methodsmentioning

confidence: 99%

A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

Wong,

Yermilov,

Dalglish

et al. 2024

Preprint

View full text Add to dashboard Cite

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Impact of comorbidities on people with and without cancer early in the COVID‐19 pandemic: An observational study

Schwartz

Rapkin

2023

Cancer Medicine

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BackgroundThe present study sought to investigate how comorbidity burden influences cancer survivors' quality of life (QoL) and the challenges/adaptations during the coronavirus disease 2019 (COVID) pandemic, and to examine how appraisal processes are related to this impact.MethodsThis cross‐sectional study, administered in spring/summer 2020, compared cancer survivors to a general‐population comparison sample. QoL was assessed with standardized tools. COVID‐specific questions included selected items compiled by the US National Institutes of Health, and cognitive appraisal processes were assessed using the QoL Appraisal Profilev2 Short‐Form. Principal components analysis reduced the number of comparisons. Multivariate analysis of covariance investigated group differences in QoL, COVID‐specific variables, and cognitive‐appraisal processes. Linear regression investigated group differences in COVID‐specific variables as a function of cognitive‐appraisal processes, QoL, demographic covariates, and their interactions.ResultsCancer survivors fared substantially better than non‐cancer participants in QoL and cognitive functioning when they had no other comorbidities, but substantially worse on QoL when they had three or more comorbidities. Cancer survivors with no comorbidities were less likely to feel worried about COVID, less likely to engage in self‐protection, and prioritized engaging in problem‐focused and prosocial actions compared to non‐cancer participants. Conversely, cancer survivors confronted with multiple comorbidities exhibited more proactive self‐protection and experienced more anxiety about the pandemic.ConclusionThe impact of having multiple comorbidities in the context of cancer is associated with notable differences in social determinants of health, QoL outcomes, COVID‐specific challenges/adaptations, and appraisal of QoL. These findings provide an empirical basis for implementing appraisal‐based coping interventions.

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A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

Wong,

Yermilov,

Dalglish

et al. 2024

JMCP

View full text Add to dashboard Cite

Impact of comorbidities on people with and without cancer early in the COVID‐19 pandemic: An observational study

Cited by 3 publications

References 44 publications

A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

Impact of comorbidities on people with and without cancer early in the COVID‐19 pandemic: An observational study

A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs

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