Understanding the Impact of Health Literacy on Access to Copay Assistance Programs

Health literacy plays a critical role in optimal health outcomes. At the forefront of this discussion is a recent white paper we published with the HealthWell Foundation. Their cross-sectional survey of the 2021 and 2022 cancer disease funds aimed to shed light on how patients' health literacy affects their access to charitable copay assistance programs.  

What is Health Literacy?

The U.S. Department of Health & Human Services (HHS) defines health literacy as the capacity of individuals to comprehend and utilize health-related information and services. Vulnerable groups, such as non-English speaking households, immigrants and those with limited education, are more likely to face challenges in health literacy. Limited literacy can hinder healthcare access and obstruct health information acquisition. The effects are profound: about 16% of cancer survivors admit to having low health literacy. This prevalence is higher in Hispanic, Black and socio-economically disadvantaged cancer survivors.  

Interpreting the Data

A recent cross-sectional study of Healthwell's 2021 and 2022 cancer disease funds investigated how patients' health literacy impacts their access to charitable copay assistance programs. A striking discovery was made when analyzing the demand for language interpreter services on the HealthWell telephone hotline. Only 0.5% of patients sought this service, despite the fact that, in 2019, 21.6% of the U.S. population above 5 years old primarily spoke a non-English language at home. This disparity might indicate barriers for non-English speakers accessing copay assistance programs.

Language is undeniably intertwined with health literacy, influencing self-enrollment via hotlines and websites. Presently, HealthWell's website is predominantly English-based. Though provisions for Spanish speakers exist, the number of patients seeking translation remains low, with Spanish dominating the requests at 96%.  

Future Initiatives

In 2021 and 2022, the two largest referral sources of patients to the HealthWell hotline were from pharmacists/pharmacy technicians (30%) and providers/physicians/nurses/advocates (24%). One-third of the total grant applicants self-enrolled via the hotline. The ability to apply for a copay assistance grant rests on adequate language skills and health literacy. To reduce this obstacle, healthcare providers often enroll on patients' behalf using HealthWell’s provider portal. This trend is clear with pharmacists, pharmacy technicians and medical professionals referring the most patients to HealthWell. To further facilitate this, HealthWell is in the process of launching a dedicated pharmacy portal, aiming to increase access to copay assistance for those with limited health literacy. Increased use of the HealthWell portal would support greater access to copay assistance for patients with low health literacy.

By working to address the challenges in this study, we can create a healthcare system where every patient, regardless of language or literacy level, has access to the financial assistance they need for critical healthcare treatments.