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Cost-Sharing Patterns for PARP Inhibitor Therapy in Ovarian Cancer

February 13, 2021

Results from a single-center study show payers incur the bulk of monthly PARP inhibitor cost for ovarian cancer. Patient out-of-pocket costs are low with 75% of patients paying <$5 per month (Gynecol Oncol. 2021;S0090-8258[20]34254-2. doi:10.1016/j.ygyno.2020.12.039).

“[PARP] inhibitors are expensive and their use is expanding,” wrote Whitney N Goldsberry, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham and colleagues.

This study aimed to evaluate cost sharing patterns between patients, payers, and financial assistance programs for PARP inhibitor therapy in ovarian cancer.

Patients who received a PARP inhibitor between May 2015 and September 2019 were identified using the University of Alabama pharmacy database. Cost information was gathered for patients who filled their prescription at the institution’s specialty pharmacy. Monthly PARP inhibitor costs were calculated for patients, payers, and financial assistance programs.

A total of 76 patients who filled 94 different prescriptions for PARP inhibitors were identified. Of these, 42 (45%) prescriptions were obtained using a financial assistance program.

Cost data were available for 41 prescriptions and analyzed over 232 months. PARP inhibitor prescriptions included rucaparib (n = 18, 44%), niraparib (n = 18, 44%), and olaparib (n = 5, 12%). 

The total average monthly drug cost was $12,422 and the median monthly drug cost was $13,700. The average monthly patient out-of-pocket cost was $46, with a median cost of $0. Payers incurred the highest average monthly cost of $12,019, with a median cost of $13,662. Financial institutions contributed an average monthly cost of $358, with a median cost of $0.

Overall, patients with public (P <.01) insurance or Medicare (P <.01) incurred higher out-of-pocket costs than those without.

“[Out-of-pocket] costs were generally low with 75% of patients paying <$5 per month,” Dr Goldsberry and colleagues concluded.

“While limited by small sample size at a single institution, financial assistance programs appear to play a critical role to ensure access to PARP inhibitors as nearly 50% of patients utilized these programs,” they added.—Janelle Bradley

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