Patient Out-of-Pocket Assistance in Medicare Part D: Direct and Indirect Healthcare Savings

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Avalere examines the effect of foundation-sponsored financial assistance on out-of-pocket costs and federal spending.
Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.

Beneficiaries enrolled in Medicare Part D, the program’s prescription drug benefit, who have high drug costs may face significant out-of-pocket expenses. Foundations like Patient Services, Inc. (PSI), provide financial assistance for premiums and cost-sharing, which can help reduce Part D medication costs for beneficiaries. Avalere examined the impact of foundation-sponsored financial assistance on patient out-of-pocket costs and federal government spending. Our analysis finds that by reducing patient out-of-pocket costs, foundation assistance can increase the number of prescriptions that patients fill, improving access and adherence, and can lead to reduced spending on medical services covered under Part A and B of the program, creating net savings for the federal government.

Access our analysis here.

Funding for this research was provided by Patient Services, Inc. Avalere Health retained full editorial control.

For more information about our Part D modeling capabilities, connect with us.

Webinar | A Closer Look at Patient Support On June 6 at 2 PM ET, Avalere experts will explore how potential implications of the Inflation Reduction Act (IRA)’s out-of-pocket cap, in addition to other key regulatory and policy activities shaping benefit design and patient cost-share (e.g., EHB), could impact patient commercial and foundation assistance. Learn More
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