Underfunding of a Patient Copay Assistance Program and the Impact on Retinal Disease Care: Survey of ASRS Members

Abstract

Purpose: To assess the impact on treatment patterns resulting from underfunding of a large patient copay assistance program (Good Days) in 2024 and 2025. Methods: A 34-item electronic survey was sent to 1860 US members of the American Society of Retina Specialists (ASRS) in April 2025 to assess the effects of Good Days underfunding. Responses were then stratified based on the social deprivation index and poverty levels of the physicians’ office locations. Results: A total of 411 responses (22%) were included. Most physicians (94%) reported significant or moderate disruptions in care after Good Days underfunding, and 90% reported patients being unable to receive their preferred drug therapy. Most physicians (93%) switched patients to off-label bevacizumab, with 84% reporting an increase in injection frequency after switching. Approximately 61% of physicians reported that vision loss was observed in patients due to cost-related delays in treatment, and 63% reported patients being lost to follow-up as a result of financial hardship. Most physicians (77%) believed that the underfunded patient copay assistance program disproportionately affected lower income or underserved communities. Physicians working in lower socioeconomic areas were more likely to report that patients requested to delay or miss therapy (50% vs 37%; P = .019), and patients with geographic atrophy were more likely to request treatment interval extensions (56% vs 44%; P = .033). Conclusions: Physicians were concerned about patients losing access to care, increasing treatment frequency with off-label therapies, and possibly losing vision after a large patient copay assistance program was underfunded. Policy makers, insurance companies, and manufacturers should work together to alleviate the financial burden and barriers to care resulting from high patient copays.