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Patient Affordability/Out of Pocket Cost (OPC)

Patient Affordability refers to a person’s ability to afford treatment, testing and other health care costs. There are significant costs associated with medical care, and some patients are unable to cover these costs or covering them causes the patient to choose between health care and other significant needs such as food or housing.

Patients and their families can find themselves in a predicament where cost of treatment can be expensive and unaffordable. While insurance can help bring the direct cost down, there are still co-pays, deductibles and out-of-pocket costs. Medications with extreme out-of-pocket costs are a critical issue for patients with chronic health issues. Out-of-pocket costs are costs that will not be reimbursed or covered by other sources. The patient will have to cover those payments with their own money. Patients with chronic health conditions are often on more than one costly medication. This can lead to extreme out-of-pocket costs with some patients having to select which of their medications they can afford each month.