Evaluation of patient support program and adherence to long-acting injectable aripiprazole for patients utilizing injection local care centers

Figures & data

Table 1. ASSURE program offerings.

Core offering	Type of support	Description
Access support	Benefit verification	Practices receive assistance from site coordinators in identifying coverage options, facilitate benefit verification and prior authorizations, and triaging applications for financial assistance programs.
	Medication acquisition	Practices that administer injections receive assistance on specialty distributor acquisition options and instructions on coding and billing information, at the individual insurer level.
	Copay assistance	Eligible patients receive commercial copay savings, which includes a low monthly copay and automatic copay reduction at select pharmacies.
Local care center	Injection centers	Patients have options to receive prescribed long-acting injectable aripiprazole from licensed healthcare professional at retail pharmacies or urgent care clinics. The local care centers (LCC) are conveniently located, offer flexible scheduling, and coordinate with nurses for ongoing patient communication and support. Enrollment into the program is not required to receive injections at an LCC.
Nurse support	Scheduling assistance, reminder alerts, and follow-up calls	Patients are connected to nurses who find LCC locations and facilitate a patient’s first treatment, provide appointment reminders and follow-up calls, and coordinate appointment rescheduling via phone, text, and/or email. External community support resources, including transportation assistance options, are also available.
Patient education	Patient transition support	Educational resources are available to help patients understand the treatment journey, by reiterating conversations initiated with the physician and serving as a continued point of reference. In addition to online support, educational brochures are available at the physician’s office.

Table 2. Characteristics of patients enrolled in the patient support program.

Patient characteristic	Patients in the program (n = 234)
Age, year
Mean (SD)	37.3 (13.5)
Age groups, n (%)
≤34	114 (48.7%)
35–44	57 (24.4%)
45–54	35 (15.0%)
55–64	16 (6.8%)
65 or older	12 (5.1%)
Gender, n (%)
Male	142 (60.7%)
Female	92 (39.3%)
Geographic region, n (%)
South	84 (35.9%)
West	93 (39.7%)
Northeast	40 (17.1%)
Midwest	17 (7.3%)
Type of payer, n (%)
Private commercial	70 (29.9%)
Medicare	76 (32.5%)
Medicaid	59 (25.2%)
Other or unknown	29 (12.4%)
Type of Health Plan, n (%)
HMO	6 (2.6%)
PPO	48 (20.5%)
POS	9 (3.8%)
Medicare Part D	35 (15.0%)
Medicare Part A & B	29 (12.4%)
Medicare Managed Care	12 (5.1%)
Medicaid	45 (19.2%)
Medicaid Managed Care	14 (6.0%)
Other	8 (3.4%)
Unknown	28 (12.0%)
Facility enrolled from, n (%)
Clinic	138 (59.0%)
Physician Office	59 (25.2%)
Hospital (Outpatient)	2 (0.9%)
Hospital (Inpatient)	17 (7.3%)
Pharmacy	18 (7.7%)

Abbreviations. HMO, Health Maintenance Organization; PPO, Preferred Provider Organization; POS, Point of Service.

Table 3. Other patient support program offerings utilized.

Service	Patients utilizing the service (n = 234)
Benefit verification	203 (86.8%)
Nurse support	170 (72.6%)
Copay assistance	31 (13.2%)
Prior authorization assistance	33 (14.1%)
Patient assistance program referral	28 (12.0%)

Figure 1. Patient cost share for long-acting injectable aripiprazole (A) Deductible (n = 47), (B) Copay, retail pharmacy (n = 123) and (C) Coinsurance, retail pharmacy (n = 55).

Table 4. Characteristics of patients in the adherence analyses.

Patient characteristic	Patients with 6 months of follow-up (n = 157)	Patients with 9 months of follow-up (n = 87)
Age, years
Mean (SD)	40 (14.3)	41 (15.5)
Age groups, n (%)
≤34	60 (38.2%)	34 (39.1%)
35–44	37 (23.6%)	19 (21.8%)
45–54	32 (20.4%)	18 (20.7%)
55–64	19 (12.1%)	11 (12.6%)
65 or older	9 (5.7%)	5 (5.7%)
Gender, n (%)
Male	97 (61.8%)	55 (62.2%)
Female	60 (38.2%)	32 (36.8%)
Preferred contact method, n (%)
Phone	140 (89.2%)	83 (95.4%)
Text	2 (1.3%)	0 (0.0%)
Email	1 (0.5%)	0 (0.0%)
Unknown	14 (8.9%)	4 (4.6%)

Table 5. Adherence to long-acting injectable aripiprazole.

Characteristics	Patients with 6 months of follow-up (n = 157)	Patients with 9 months of follow-up (n = 87)
Total no. of injections
Mean (SD)	6.74 (0.52)	9.78 (0.65)
Median	7.00	10.00
Adherence, proportion of days covered (PDC)
Mean (SD)	0.98 (0.02)	0.97 (0.02)
Median	0.98	0.97
Adherent to treatment, n (%)
PDC ≥80%	157 (100.0%)	87 (100.0%)
Time on treatment (days)
Mean (SD)	177.67 (4.30)	266.08 (5.99)
Median	178.00	266.00