A Guide to Patient Assistance Programs for Prescription Medications Posted: February 19th, 2010
Have you ever found yourself standing at the pharmacist's counter debating whether or not to purchase the medication you need because it's too expensive? All too often, patients forego needed prescription drugs because the cost of medication is too high.
Some patients choose to get prescriptions filled but then make the risky decision to take half the dose prescribed to double the life of the prescription. Even if you have generous health insurance coverage, many medications cost more than some patients can afford.
If you find yourself struggling to pay for your prescription medications, patient assistance programs may provide a solution.
What Are Patient Assistance Programs?
Patient assistance programs (PAPs) are programs offered by drug makers to provide free or discounted medications to patients who cannot afford their prescriptions.
Most, if not all, major drug manufacturers have some type of PAP in place to allow those who need prescription drugs to get them at a price that they can afford. In many cases, the medication is free to those who qualify for the drug maker's program.
Eligibility requirements vary, but PAPs are generally intended for low-income patients without health insurance, who need medication and who cannot afford to purchase it.
Tips for Finding the Right PAP
With many PAPs to choose from, how do you find the right one? Here are several tips for finsing the right PAP for your needs:
- Determine the maker of your prescription medication. Call the drug manufacturer and ask if they have a patient assistance program
- Ask your doctor to help you find the right PAP. Many of programs work directly with doctors, so there's a good chance that your physician might know how to get you started with the right program
- Review the major PAPs listed below to see if they cover the prescriptions you need, and whether or not you meet their eligibility requirements
Comprehensive Patient Assistance Programs
There are several comprehensive resources that you should consult when searching for a PAP. These organizations often work with dozens, and sometimes even hundreds, of drug makers to assist a wide range of patients.
Eligibility for each program varies depending on the medication that you need, but most programs require participants to be U.S. citizens or legal residents, without health insurance coverage, who are facing financial hardship.
The Partnership for Prescription Assistance (PPA) aggregates information from nearly 500 different PAPs. There are almost 100 drug companies working with this program. To apply, you must submit one application to this organization. Once the application has been review, you are matched with independent PAPs that you may qualify for.
Rx Assist is an online database of information that can be used to find PAPs. You provide the relevant information about the prescription drugs that you need, and the financial situation that you are in, and you are directed to the specific program that may best suit your needs.
This program offers more than 300 different prescription medications at approximately 25%-40% of normal costs. To qualify you must be a low-income U.S. resident without prescription drug coverage, and ineligible for other programs such as Medicare.
Specific Major PAPs
In addition to the comprehensive programs listed above, there are several major patient assistance programs that are operated directly by drug makers. Some of the most important ones for you to look into are here. Note that some of these programs advertise specific drugs under their general program but also cover certain drugs under separate plans. Always check the maker of your prescription drug and call them directly if you have any questions about coverage.
100 Abbott Park Rd., Abbott Park, IL 60064-3502
Drugs: Depakote, Humira, Isoptin, Lupon Depot, Tricor, and other Abbott Laboratories medications
For treatment of: Multiple health issues
This program uses the Federal Poverty Guidelines to determine eligibility; however, it also considers extenuating circumstances on a case-by-case basis. If you are living above the poverty level, but are uninsured and in need of assistance, you should consider contacting Abbott Laboratories.
Access Virology Patient Assistance Program
Drugs: Baraclude, Reyataz, Sustiva
For treatment of: HIV, HBV
This is a Bristol-MyersSquibb program specifically designed for low-income patients who need HIV or HBV medication but cannot afford the treatment. The program only covers generic prescriptions, and you must be a legal U.S. resident to qualify.
1800 Concord Pike, P.O. Box 15437, Wilmington, DE 19850-5437
Drugs: AstroZeneca medications like Crestor, Seroquel and Prilosec.
For treatment of: Multiple health issues including cardiovascular, gastrointestinal, neuroscience, oncology, and respiratory issues.
If you earn $30,000 per year or less as an individual, or twice that as a family of four, you might be eligible for this program.
Aton Pharma PAP via NORD
Drugs: Cuprimine, Demser, Edecrin, Lacrisert, Mephyton, Syprine.
For the treatment of: Wilson's Disease, Rheumatoid Arthritis, Cystinuria, pheochromocytoma, edema associated with congestive heart failure, cirrhosis of the liver, renal disease, idiopathic edema, lymphedema; dry eye syndromes, and vitamin k deficiency.
Patients who are uninsured are required to request a pre-screen exam to determine eligibility for this program.
900 Ridgebury Rd., P.O. Box 368, Ridgefield, CT 06877-0368
Drugs: Aggrenox, Aptivus, Atrovent HFA, Catapres-TTS, Combivent, Flomax, Micardis, Mirapex, Serentil, Spiriva, Viramune.
For treatment of: Multiple health issues including cardiovascular, respiratory, and HIV.
Eligibility for this program requires that the uninsured individual meet certain low-income requirements. The program aims to provide assistance to the elderly and low-income families.
345 Park Avenue, New York, NY 10154-0037
Drugs: Abilify, Avalide, Avapro, BiCNU, BuSpar, CeeNu, Desyrel, Droxia, Etopophos, Lodosyn, Lysodren, Onglyza, Orencia, Plavix Prolixin, Vumon.
For the treatment of: Multiple health issues including cancer, HIV, and psychiatric conditions.
This PAP is available to legal U.S. residents without prescription drug coverage who are facing financial hardship. Application forms must be submitted by both the patient and doctor to qualify.
Drugs: Erbitux, Ixempra, Sprycel
For the treatment of: Cancer-related diseases.
This program is for patients without health insurance coverage who meet financial guidelines for low-income medication. Insured patients may also use this program to receive assistance through reimbursement for prescriptions.
Lilly Corporate Center, Indianapolis, IN 46285
Drugs: Lilly medications including Alimta, Humulin, Cymbalta, Cialis, Prozac and Evista
For treatment of: Multiple health issues including cancer, diabetes, ED, depression, and growth hormone issues.
Patients must be US residents without health insurance who have an annual income at or below 300% of the current Federal Poverty Level.
13600 Shoreline Drive, St. Louis, MO 63045
Drugs: Forest Medications such as Celexa, Lexapro, Savella, Tiazac.
For treatment of: Multiple health issues including cardiovascular, central nervous system, and respiratory diseases.
General income and health insurance criteria must be met. Specific eligibility is determined based on a questionnaire filled out by the patient and doctor.
One Franklin Plaza, P.O Box 7929, Philadelphia, PA 19101
Drugs: Over 50 GSK Medications, including Advair, Paxil, Wellbutrin.
For treatment of: Multiple health issues, including respiratory and psychiatric.
GlaxoSmithKline (GSK) has several different PAP programs. Their main program, Bridges to Access, has standard income and health insurance eligibility requirements -- other (GSK) programs may be more lenient.
Medtronic via NORD
Drugs: Lioresal Intrathecal (baclofen injection).
For treatment of: severe spasticity.
This PAP is meant to provide assistance to low-income, uninsured U.S. residents.
Drugs: Cosopt, Cozaar, Hyzaar, Janumet, Januvia, Maxalt, Singulair, Trusopt, and other Merck drugs may qualify.
For the treatment of: Multiple health issues including endocrinology, infectious disease, and women's health.
There are three requirements to qualify for this program:
- You must be a U.S. resident with a prescription for a Merck medication written by a licensed U.S. doctor
- You must not have health insurance and cannot qualify for other assistance programs like Medicare
- You are facing financial hardship
One Health Plaza, East Hanover, NJ 07936-1080
Drugs: Clozaril, Ludiomil, Tegratol, and 50 other Novartis products.
For treatment of: Multiple health issues including respiratory, immunology, and neuroscience.
General income and insurance requirements apply for eligibility; call for details.
235 East 42nd St., New York, NY 10017-5755
Drugs: All Pfizer Medications (such as DepoProvera and Zoloft).
For treatment of: Multiple health issues including psychiatric and women's health.
Pfizer offers over half a dozen different patient assistance programs to help patients pay for variety of medications. Eligibility varies depending on the exact needs of the patient.
Rare Disease Therapeutics, Inc. via NORD
800-999-6673 (for Cystadine), 888-454-8860 (for Orfadin)
Drugs: Cystadine, Orfadin.
For treatment of: Homocystinuria, Hereditary Tyrosinemia Type I.
Standard eligibility requirements are in place, such as lack of health insurance and low income.
340 Kingsland St., Nutley, NJ 07110-1199
Drugs: All Roche products may be covered.
For treatment of: Multiple health issues including anemia, STDs, infectious diseases.
Eligibility for this program varies depending on which Roche drugs are needed. Contact the company via phone to discuss details.
Sigma-tau Pharmaceuticals, Inc. via NORD
Drugs: Carnitor (L-Carnitine or levo carnitine).
For treatment of: Primary systemic carnitine deficiency, dialysis, chronic fatigue syndrome (CFS), several rare metabolic disorders.
Standard eligibility requirements are in place.
5 Giralda Farms, Madison, NJ 07940
800-934-5556, option #1
Drugs: Effexor, Phospholine Iodide, Premarin, Premphase, Prempro, Pristiq, Protonix, Trecator.
For Treatment of: Multiple health issues including women's health, allergies, and neuroscience.
Eligibility requirements for this program include income of less than 200% of the current poverty guidelines set forth by the Department of Health and Human Services, inability to pay for medication, and lack of health insurance. Note that Wyeth is now a subsidiary of Pfizer, but the Wyeth prescription assistance program has not changed.
Patients who wish to conduct further research should consult the comprehensive, alphabetized list of all PAPs available at Rx Hope.