What Patient Support Program big data reveals about changing drug-purchasing behavior

Northern Taiwan has the highest enrollment share

     Recent observations by the PatientsForce data science technology team (first half of 2024) across Taiwan's patient drug support programs show that nearly 60% of enrollees come from the north, followed by over 30% from central Taiwan, only about 10% from the south, and less than 1% from the east. This distribution correlates with where the diseases covered by the programs are treated and how medical resources are distributed, but our observations also point to differences in the financial capacity of self-paying patients across regions.
        In addition, whether healthcare institutions have sufficient resources to help patients apply for support programs and to assist with referrals and explanations also limits program utilization in certain areas. In hospitals in remote or less developed regions, rolling out patient support programs is even harder, and overcoming these challenges requires more supporting measures and management strategies to ensure patients can access the programs equitably.
        Managing a patient support program involves strict requirements not only for application approval, information protection, patient privacy, and treatment journey timelines; where a donation scheme requires coordinating with a hospital's pharmacy stock or adding data management to the hospital information system, it demands not only lengthy preparation and administrative work but also corresponding support from clinical staff—indirectly affecting whether patients get the chance to enroll. In the past, hospital clinical-administrative constraints have indeed prevented patients from accessing support programs equitably.
       Institutional and clinical policies on self-paid medicines can also have an impact. Overall, medical centers account for the largest volume of patient applications.

Patient purchasing habits: why buy at the hospital rather than the pharmacy?

        Looking at where patients buy self-paid medicines, even for oral self-paid prescription drugs, 56% of Taiwan's self-paying patients still purchase during hospitalization, another 24% buy through outpatient visits, and only about 20% go to a pharmacy. The main reason is likely the influence of private insurance coverage: patients in Taiwan receive more private insurance protection when collecting medicines during inpatient stays and outpatient visits, and inpatient coverage limits are higher than outpatient ones, indirectly shaping self-paying patients' purchasing behavior. Self-paid drug sales are also currently a major revenue source for hospitals, and buying in-hospital is simply more convenient.
        Moreover, in every region of Taiwan, inpatient purchases lead with more than half of the total. In the north and south, the share of pharmacy purchases slightly exceeds outpatient purchases, whereas in central Taiwan pharmacy purchases are clearly lower than outpatient purchases. This shows that purchasing is shaped by both drug supply channels and regional purchasing environments, which may differ: some self-paid medicines may be supplied only through hospitals, leaving pharmacies unable to sell them directly and keeping pharmacy volumes low. Patients may also prefer buying medicines at hospital outpatient clinics, since they can complete their visit and pick up their medicines in one place without a separate trip to a pharmacy.

A recent decline in patients' capacity for single high-cost purchases

        Most self-paid oral medication schemes are designed so that after a patient accumulates a certain period of self-paid (purchased) drug treatment, they get a financial breather and can apply for free donated treatment. In some oral self-paid drug programs, patients (payers) generally purchase in installments according to their current ability to pay (their financial situation or per-claim insurance caps)—buying by the tablet, for example—and can only apply for the donation once their accumulated self-paid purchases meet the threshold.
        Recently, in some donation support schemes, we have observed a downward trend in the amount (value) patients purchase each time, which may indicate that their current ability to pay is weaker than before. In the first half of this year, aside from a clear dip in February—when Taiwan's Lunar New Year holidays reduced the number of self-paid receipts submitted for donation applications, with a recovery in March and April—the overall first-half trend shows that in some long-term treatment programs, patients' per-purchase spending has declined. This may reflect changes in patients' ability to pay, though longer observation is still needed.
        By tracking these big data shifts, we can report back to the sponsors of patient support programs (Plan Owners) and optimize resources and services with healthcare institutions, so that support better matches what patients need in the real world. The goal is to give patients who need treatment more opportunities and resources to access their medicines—which makes an efficient patient support management system essential.