The Patient Access Network Foundation: Support Services for Patients with Cancer
Interview with Daniel J. Klein
Q Based on your experience at PAN, what are some of the main difficulties facing patients with cancer today?
Mr Klein: The biggest difficulty facing patients with cancer is the high cost-sharing related to current treatments. Many new therapies available today tend to be expensive. The types of health insurance plans that many people have include a high deductible and high copays for treatments. It’s not unusual for patients with cancer to pay $10,000 or more out of pocket for a treatment, even just for the prescription medications that they need. The financial burden that patients face when they have cancer is really the biggest challenge for them.
Q What types of support programs does the PAN Foundation offer to patients with cancer?
Mr Klein: PAN offers 3 types of support. First, we offer copay assistance, by providing grants to patients who need help with their deductibles, their copays, or coinsurance. Second, for patients with some types of cancer, we offer help with their travel expenses. And, third, we offer patients some help with insurance premiums, although those are much more limited programs. Overall, we provide copay assistance for more than 20 different cancer diagnoses but we provide travel and premium assistance just for a few diagnoses.
Q In addition to financial support services, what other kinds of services does the PAN Foundation offer patients with cancer?
Mr Klein: When a patient with cancer comes to us for financial assistance, we also link that patient with one of our patient advocacy partners that is specific to the cancer the patient has. At PAN we are focused on providing the financial assistance, and our patient advocacy partners provide other types of support. We have partnerships with more than 12 patient advocacy groups.
For example, we partner with Living Beyond Breast Cancer for patients with breast cancer, and we partner with Us TOO for patients with prostate cancer. Those partner organizations offer a range of patient support services that are complementary to what we provide at PAN, such as case management services, peer support, patient education, and navigation support.
Patients can also visit our website and go to the section called “Patient Resources,” which will connect them directly to support organizations and to other resources they may need.
Q What are the requirements to qualify for financial assistance through PAN?
Mr Klein: To be eligible for nearly all our programs, patients need to (1) be at or below 400% or 500% of the federal poverty level; (2) reside in the United States; (3) receive treatment in the United States; (4) have one of the diagnoses that we cover; and (5) use a drug that is covered by their insurance plan for that diagnosis. Patients can check our website to see the eligibility requirements for each of the programs we offer.
Of note, we provide assistance to patients who have primary insurance, either Medicare or commercial insurance, and we don’t provide assistance to patients who have no insurance. However, if patients don’t have insurance, we refer them to other programs that can help them.
Q How long does the approval process for assistance take, and how do patients know if they can get assistance?
Mr Klein: Our process is very easy and quick. It takes about 10 minutes to enroll. Patients can either contact our call center (866-316-7263) to enroll or enroll at our website through the portal. They will immediately find out whether they will receive a grant from PAN, and if they do, they can use that grant immediately. As soon as they receive the grant, we give them a Virtual ID Card, which they can use at the pharmacy or at their provider’s office.
Q Are oncologists aware of all the support services available to patients through PAN? What could be done to increase their awareness of those?
Mr Klein: We believe that most oncology practices are aware of PAN and our services. We do a lot of outreach to educate oncology practices. We know through our participation in groups such as the National Community Oncology Dispensing Association that oncology practices are aware of us, and they use us.
We have portals for healthcare providers, as well as for pharmacies, to enroll their patients directly. Probably 50% of our enrollees come directly from providers or from the pharmacies requesting grants on behalf of patients.
In addition, we continue to do outreach, and have newsletters for healthcare providers and for pharmacies. We also have a strong presence on social media; we try to ensure that providers are aware of us, and know how to enroll their patients.
Q How can practice managers and financial counselors help patients with cancer access your support services?
Mr Klein: There are many ways that providers can get support. The best way is to visit our website or to contact our call center; this allows us to help the practice managers or administrators to enroll patients who need assistance. We work with providers to help them enroll patients and get their claims paid. We provide a high level of support and try to monitor whether providers are getting the help they need.
Indeed, we generally get very high marks for being patient- and provider-friendly. We continue to reach out to providers, and offer them webinars and newsletters about our services. We also send our staff to provider offices to help them learn how to enroll patients or submit claims.
Q Do you have any advice for oncologists who want to address financial issues with their patients, but don’t know how to do it?
Mr Klein: The critical factor for oncologists is to realize that many patients with cancer need financial assistance. We recently did a survey with our patient advocacy partners of nearly 2000 patients; many of those patients had cancer. We found that essentially 100% of patients with cancer said that they needed financial assistance to help pay for their medications.
The message to healthcare providers is that it’s very likely that the patients they’re seeing need financial assistance; it’s more likely that they need assistance than that they don’t need assistance. Healthcare providers should ask their patients if they need help, and they should assume that their patients do need help rather than the other way around.
Q Have you seen an increase in the number of applications for financial support in the past year?
Mr Klein: Absolutely. We have seen a steady increase in the number of patients who need help and ask for assistance. Because of the way health plans design their benefits today to include high-deductible plans and high cost-sharing for specialty medications, we see growing numbers of patients who need assistance; however, the amount of assistance is also growing.
Q Is there anything else you would like to add about the PAN Foundation?
Mr Klein: The funding that PAN has changes all the time, so a program may be closed one week and then open the next week. Our website shows what funds are available at the moment, so patients and practice managers or providers can take advantage of whatever assistance we have at that point. Keep in mind that if we can’t help someone, we will refer that person to other assistance programs that may be able to help him or her.