Value, limitations of patient assistance programs for women with breast cancer

Most breast cancer patients who had information about patient assistance programs used them to learn more about adjuvant therapy, obtain psychosocial support, and overcome practical/financial obstacles to getting treatment, reported researchers from the Icahn School of Medicine at Mount Sinai.

Researchers found that, in most cases, patients who were referred to assistance programs did contact organizations running programs, such as Cancer Care Inc., SHARE, and the Mount Sinai Breast Health Resources Program.

"Doctors have been frustrated by data showing that perhaps as many as 20 percent of women with breast cancer -- especially black and Hispanic women -- do not take advantage of lifesaving adjuvant therapies," said Nina Bickell, MD, MPH, Professor of Health Evidence and Policy and Professor of Medicine at Mount Sinai. "Some women lack critical information about the value of these treatments, while others need help dealing with the emotional aspects of breast cancer treatment or with practical matters such as transportation, insurance, or childcare before taking the next step. Fortunately, there are many high-quality patient assistance programs that can help women address these issues."

For the study, Dr. Bickell and her team recruited 374 women with early-stage breast cancer who had recently undergone breast surgery. The researchers conducted a brief assessment to identify women who needed information, psychosocial support, or help with practical issues that might affect access to treatment. Half of the women received a customized list of patient assistance programs, based on findings from the needs assessment, and an individualized action plan; the other half received a New York State Department of Health pamphlet about breast cancer that includes a list of local resources.

The vast majority of women in the study reported some type of need, regardless of the type of information they received. Nearly 80 percent of women who contacted a patient assistance program, had some or all of their needs met, compared with only 35 percent of those who did not connect with a program. The programs were particularly effective in meeting women's needs for information about adjuvant treatments or counseling. However, very few women in either group reported that they had obtained sufficient help in overcoming practical obstacles to treatment.

Most women in the study went on to get the adjuvant therapy recommended by their doctor. Treatment rates were nearly identical in both groups of women, regardless of the type of information they received.

"We were delighted to discover that most of the women in our study who needed some type of assistance had a successful encounter with a patient assistance program and got the treatments they needed," said Dr. Bickell. "Nevertheless, national statistics suggest that women in the U.S. continue to face economic and logistical barriers to getting adjuvant therapy for breast cancer. To ensure that patient assistance programs have the greatest impact on reducing national disparities in care, private philanthropies, which represent the biggest source of funding for these valuable programs, will be challenged to increase development in this area.