If your doctor prescribes an expensive drug and youre uninsured or cant afford the co-pays, dont despair. So-called patient-assistance programs, many of them run by pharmaceutical companies, are available to help you get the drugs you need.
Each patient-assistance program sets its own eligibility requirements. The income limits vary widely, from 100% of the federal poverty guidelines (which in 2009 stood at $22,050 for a family of four) to over 300% of the guidelines, according to Rich Sagall, MD, president of NeedyMeds, an online clearinghouse of information for people who cannot afford medicine.
Most patient-assistance programs require the applicant to be an American citizen or legal resident, and most are restricted to the uninsured. "Most programs help people with no insurance, but some will help the underinsured," says Dr. Sagall. For instance, some companies will provide medications to patients who have reached the limit of their prescription insurance; others help people on Medicare Part D, the federal drug-subsidy program. In general, however, if you qualify for government-funded programs (such as Medicaid), you probably will not be eligible for most patient-assistance programs.
For a comprehensive directory of available patient-assistance programs (including which programs offer which drugs), visit NeedyMeds. Some programs run by pharmaceutical companies require your physician or another advocate to register you. If your doctor isnt available to help and you need someone to act on your behalf, or if you just need some help with the paperwork, NeedyMeds can direct you to an advocate in your area.
Additional sources of information on free or reduced-cost prescriptions:
- American Society of Health-System Pharmacists (ASHP). This organization offers a list of frequently asked questions and links to directories of patient-assistance programs.
- Partnership for Prescription Assistance (PPA). The website of the PPA, a national program sponsored by Americas pharmaceutical research companies to help patients in need of access to prescription medicines, features an online application wizard that can help patients determine which patient assistance programs they may be eligible for.
- RxAssist. A pharmaceutical information center created by Volunteers in Health Care, RxAssist offers a comprehensive database of patient-assistance programs.
- The Patient Advocate Foundations Co-Pay Relief Program. If you have insurance but are still struggling with high costs for medication, this program gives financial aid to patients who meet certain income qualifications and who are being treated for chronic conditions such as cancer, certain autoimmune disorders, and secondary issues resulting from chemotherapy.
- Medicare Rights Center. An independent source of health-care information and assistance for people with Medicare.