OBJECTIVES : Patient Assistance Programs (PAP) are usually initiated by pharmaceutical companies or non-profit charity organizations. They aim at offering drug products to eligible patients free of charge or at a lower price. Chronic Obstructive Pulmonary Disease (COPD) is one of the chronic respiratory conditions that has long disease course and various complications, requiring long-term care and incurring large medical expenses. This study intends to detail an methodology in designing PAP scheme within a socioeconomic context.

METHODS : WHO proposes that health expenditure is viewed as catastrophic whenever it is greater than or equal to 40% of household’s income. Previous study has showed that direct medical cost of COPD is estimated 40% of annual household disposable income, an additional 65% reimbursement coverage on COPD treatment from National Reimbursement Drug List (NRDL)

Household’s non-subsistence income is measured as the annual disposable income obtained from China Statistical Yearbook. Distribution of income and corresponding proportion of households is then adjusted to a normal distribution.

In this study, we assumed there is only one COPD patient in a household, and discrepancies in prevalence of COPD among age groups and income levels are not considered.

RESULTS : Distribution of household’s non-subsistence income is mapped into levels of lower (11%), lower-middle (30%), middle (25%), upper-middle (15%) and upper (19%), with annual household disposable income of RMB 48,901, RMB 84,487, RMB 119,632, RMB 167,141 and RMB 288,599, respectively. The economic burden of COPD patients with direct medical cost is 25,515 RMB per year.

CONCLUSIONS : Households with annual disposable income less than RMB 63,788 are considered as suffering from catastrophic health expenditure, thus set to be the economic criterium in developing PAP. Hence, around 30% of the COPD households would be eligible for PAP support.