New 2025 Medicare LIS Enrollment Data for Market Access Execution

2025 LIS Data Updates

In Q2 of each year, the Centers for Medicare & Medicaid Services (CMS) releases annual Medicare Low-Income Subsidy (LIS) enrollment totals by county. Used in combination with other CMS enrollment datasets, biopharma professionals can determine the influence of the approximately 14 million 2025 LIS beneficiaries distributed across each of the United States’ 3,000+ counties.

The Importance of the Medicare LIS Benefit

The Medicare Low Income Subsidy (also known as “Extra Help”) allows low-income patients with minimal assets to obtain drug coverage with no monthly premium payments or deductibles. An important aspect of this program is that these patients can access branded medications that may otherwise be unaffordable for minimal LIS co-payments ($12.15 or less). By lowering co-pays and other drug-related costs, LIS benefits can increase patient access to covered medications and therapies.

Low Income Subsidy (LIS) beneficiaries make up approximately 27% of the overall Medicare Part D population, making them an important patient group to reach with new and innovative therapies. Unfortunately, LIS patients are notoriously hard to identify. They don’t carry an “LIS card” to indicate their status, so HCPs and office staff must rely on certain qualifiers, such as estimated incomes/assets or dual eligible Medi-Medi status, to help identify them.

An Integrated LIS Market Access Strategy

LIS enrollment data provides a strategic blueprint to help find these patients, allowing manufacturers to focus educational efforts on HCPs and office staff in areas with concentrated LIS populations. For example, some counties have a Medicare population that consists of more than 50% LIS patients, while others may be in the single digits. A focused, data-driven LIS campaign can therefore be an efficient way to direct efforts towards supporting LIS patients.

Biopharma companies that incorporate LIS data into their market access strategies will be in a better position to locate LIS recipients and support prescribers by clarifying access to therapy for these patients. Ideally the number of rejected or abandoned prescriptions could be reduced, and more patients would be able to both start and stay on their prescribed therapies.

The Advantages of a Market Access Platform

A market access platform like AccessSync^® One enables teams to combine LIS analytics and strategies with targeted messaging for prescribers and office staff. Available tools and supporting services include:

• Territory-level strategic segmentation to target providers in high LIS areas with focused access messaging and resources
• Territory overlays to identify which Sales Representatives and/or FRMs are best positioned to engage in a focused LIS campaign
• Customized LIS messaging embedded in pre-call planning and automated pull-through resources to correct access misperceptions
• Integration with claims and co-pay datasets to understand which prescribers are likely to see higher concentrations of LIS patients

LIS Market Access Webinar

Check back for details about our upcoming LIS webinar that will highlight recent changes to LIS populations and demonstrate specific tactics to deploy across field teams to help patients in need gain access to needed therapies.

Want to learn more?

Contact us to learn how we can help your team achieve your market access goals.