Evaluating enrollment processes and eligibility criteria of manufacturer free-drug patient assistance programs for oral anticancer agents used in hematologic malignancies.

117 Background: Increasing costs of oral anticancer agents (OAAs) pose a major barrier to patient adherence and consequently treatment effectiveness. While patient assistance programs (PAPs) may help cover costs, eligibility requirements for these programs are anecdotally reported to be non-transparent and enrollment processes burdensome, limiting their accessibility to patients. Thus, we evaluated the eligibility criteria and enrollment processes of manufacturer free-drug PAPs. Methods: A prospective review of manufacturer free-drug PAPs available for OAAs used in hematologic malignancies was conducted between October 2023 and February 2024. Available PAPs were identified using three online databases: RxAssist, NeedyMeds, and Association of Community Cancer Centers . Financial support program websites were assessed to gather information on eligibility requirements, enrollment processes, and other PAP characteristics. Results: For the 45 OAAs evaluated, 23 manufacturer free-drug PAPs were identified. All PAPs had insurance and income eligibility requirements which varied between programs. Uninsured patients were eligible for all programs, with 4% of programs restricting eligibility to only uninsured patients. The most common income eligibility threshold was 500% federal poverty limit, and requirement details were unavailable for 43.5% of programs. Enrollment could be initiated online, via downloadable form, and by phone-call, with 61% of programs having all three methods of enrollment initiation available to providers (17% to patients), 35% having two to providers (22% to patients), and 4% having only one to providers (52% to patients). Of note, 9% of programs offered no way for patients to independently initiate enrollment. Enrollment for all programs required both patient and provider inputs, and submission methods for some or all enrollment documentation included fax, online portal, email, and mail, with 4% of programs having four methods of submission available, 26% having three, 52% having two, and 17% having only one. Conclusions: The pathways for patients or providers to enroll in Patient Assistance Programs (PAPs) are complex and inconsistent across different programs, often requiring more action from providers than patients. Additionally, there is frequently a lack of transparency in the eligibility requirements for manufacturer free-drug PAPs.