Prescription for Better Access

With pharmaceutical and biotech manufacturers launching more high-cost specialty drugs and the insurance industry increasing the use of more restricti…
Nov 16th, 2023 | 40:00

Episode 12: How Alternative Funding Programs Exploit Patient Assistance Programs

In this episode, we investigate the rise of Alternative Funding Programs (AFPs) that bypass coverage for vital specialty drugs.  Kyle Crowell, an expert consultant on AFPs, discusses how payers avoid their responsibility for costs by collaborating with third-party companies to exclude specific drug coverage and directing patients towards manufacturer-sponsored patient assistance programs (PAPs).  Patient advocate, Amy Niles from the PAN Foundation, describes how the mounting tension caused by AFPs are leaving patients to navigate the uncertain waters of their medication coverage and access, potentially risking their health and even their lives.

Kyle Crowell, Principal (Partner) at ZS Associates

Amy Niles, Chief Advocacy and Engagement Officer, PAN Foundation

Patient Assistance programs (PAPs)

Alternative funding programs (AFPs)

“AFP Caution For Patients”

“Pharma faces tough choices as alternative funding programs exploit charitable giving”

Medicare Part D

“AbbVie sues a behind-the-scenes company for exploiting its patient assistance program”

Federal Trade Commission

Carl Schmidt from the HIV and Hepatitis Policy Institute

Copay Accumulator Adjustment Programs Lawsuit

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