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Information

Resources for Accessing Hepatitis C Treatment

May 28, 2015

Pharmaceutical Company Patient Assistance Programs

What Is a Patient Assistance Program (PAP)?

A patient assistance program (PAP) is a program run through pharmaceutical companies to provide free or low-cost medications to people with low-incomes who do not qualify for any other insurance or assistance programs, such as Medicaid, Medicare or AIDS Drug Assistance Programs (ADAPs). Each individual company has different eligibility criteria for application and enrollment in their patient assistance program.

The following provides an overview of PAP contact information, drugs covered and financial eligibility criteria.


CompanyContact InformationDrugs CoveredFinancial Eligibility
For Hepatitis B Virus (HBV)
Bristol-Myers Squibb855-898-0267
www.bmspaf.org
Baraclude300% FPL
Gilead Sciences800-226-2056
www.gilead.com/us_advancing_access
Hepsera and Viread500% FPL
GlaxoSmithKline866-475-3678
www.gskforyou.com
Epivir250% FPL
For Hepatitis C Virus (HCV)
AbbVie844-2-PROCEED or
www.viekirahcp.com
Viekira Pak500% FPL
Gilead Sciences855-769-7284
www.mysupportpath.com
Harvoni500% FPL
Gilead Sciences855-769-7284
www.mysupportpath.com
Sovaldi500% FPL
Genentech/Roche888-941-3331
www.pegasysaccesssolutions.com
Pegasys and CopegusHousehold income <$100,000 per year
Janssen Therapeutics800-652-6227
www.Jjpaf.org
Olysio500% FPL
Merck and Co.866-363-6379
www.merckhelps.com
Pegintron and Victrelis500% FPL
Vertex Pharmaceuticals855-837-8394
www.incivek.com
IncivekHousehold income <$100,000 per year


Pharmaceutical Company Cost-Sharing Assistance Programs

What is a Cost-Sharing Assistance Program (CAP)?

A cost-sharing assistance program (CAP) is a program run through pharmaceutical companies to offer cost-sharing assistance (including deductibles, co-payments and co-insurance) to people with private health insurance to obtain viral hepatitis drugs at the pharmacy.

The following provides an overview of CAP contact information, drugs covered and assistance offered.


CompanyContact InformationDrugs CoveredAssistanceRenewal
For Hepatitis B Virus (HBV)
Bristol-Myers Squibb855-898-0267 or
www.baraclude.com
BaracludeProgram participants are given a card that ensures coverage of the first $200 per month of co-payments. For people who pay for their prescriptions in full, the program will also cover the first $200 per month.Can use card for up to 12 monthly co-pays within 1 year.
Gilead Sciences877-627-0415 or
www.gilead.com/us_advancing_access
VireadThe program starts after the first $50 and covers up to $200 per month co-payment for Viread for HBV treatment for patients who are uninsured or pay their prescription costs in full.Automatically renews annually for enrolled patients.
GlaxoSmithKline877-844-8872 or
www.mysupportcard.com
EpivirProgram participants are given a card that ensures coverage of up to $200 dollars per prescription per month and includes non-HBV drugs.Must request a new card for each prescription.
For Hepatitis C Virus (HCV)
AbbVie844-2-PROCEED or
www.viekirahcp.com
Viekira PakThe program covers up to $5,600 for each prescription for a maximum of $67,200. Individuals must have an out-of-pocket cost greater than $5 and must not have federally-funded prescription coverage.No renewal; one coupon per lifetime.
Gilead Sciences855-769-7284 or
www.harvoni.com
HarvoniThe program covers up to a maximum of 25% of the price of a 12-week regimen after payment of first $5 per prescription fill.No renewal; one coupon per lifetime.
Gilead Sciences855-769-7284 or
www.gilead.com/us_advancing_access
SovaldiProgram participants are given a card that ensures coverage of up to 20% of the cost of each prescription for a maximum of $16,800. Co-payment charges range from $5 and $25 per prescription. The program covers people who do not qualify for other assistance and people with a household income of up to $100,000 per year for a household of 1 to 3 people and 500% of the FPL for households of 4 or more.Must request a new card for each prescription.
Janssen Therapeutics855-565-9746 or
www.OLYSIO.com
OlysioProgram participants are given a card that ensures coverage of co-payments up to a maximum of $50,000, 12 months after activation or a 12-week supply, whichever comes first. Patients pay a maximum $5 co-payment per fill.Must request a new card for each prescription.
Merck and Co.866-939-4372 or
www.pegintron.com
www.victrelis.com
PegIntron and VictrelisThe program provides participants with a coupon that guarantees $200 savings on co-payment for each Pegintron prescription, on up to 12 prescriptions. Up to 20 percent savings of the total cost of each Victrelis prescription, on up to 12 prescriptions.New coupon must be obtained for every 12 prescriptions.
Vertex Pharmaceuticals855-837-8394 or
www.incivek.com
IncivekThe program provides participants with a coupon that covers co-payment costs up to $10,000 for people who have private insurance plans that cover Incivek, regardless of their household income. Vertex Pharmaceuticals will be extending co-payment benefits to all Affordable Care Act Qualified Healthcare Plan marketplace clients.No renewal; one coupon per lifetime.


Foundations Providing Access to Care Assistance for People Living with HBV and/or HCV

  • Chronic Disease Fund
    The Chronic Disease Fund’s co-payment and medication assistance program provides financial assistance to eligible individuals.
  • HealthWell Foundation
    The HealthWell Foundation’s co-payment assistance program provides up to $15,000 in financial assistance to eligible individuals for HCV treatment. Eligible patients include those who are insured and have an annual household income of up to 500% of the federal poverty level (FPL).
  • Needy Meds
    Needy Meds offers resources that are helpful to uninsured and underinsured patients including an MRI/CAT scan discount program and medical bill mediation.
  • Patient Access Network Foundation
    The Patient Access Network (PAN) Foundation offers help and hope to people with chronic or life-threatening illnesses, including HIV and hepatitis, for whom cost limits access to medical treatments.
  • Patient Advocate Foundation Co-Pay Relief Program
    The Patient Advocate Foundation (PAF) Co-Pay Relief Program (CPR) provides direct financial support to insured patients, including Medicare Part D beneficiaries, who financially and medically need assistance paying prescription medication co-payments, co-insurance and deductibles relative to their diagnosis.
  • RxOutreach
    RxOutreach is a mail order pharmacy for people with little to no health insurance coverage.


Additional Resources

The following resources may be of interest to individuals living with viral hepatitis.

  • Clinical Trials
    A service of the U.S. National Institutes of Health, ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world.
  • Fair Pricing Coalition (FPC)
    As part of their advocacy work, the Fair Pricing Coalition (FPC) negotiates with companies to ensure that Patient Assistance Programs (PAPs) are adequately generous and easy to apply for.
  • Health Insurance Marketplace
    The official site of the Health Insurance Marketplace, Healthcare.gov allows individuals and families to sign-up for insurance coverage through the Affordable Care Act.
  • Help-4-Hep
    Help-4-Hep is a non-profit toll-free helpline for those with concerns about hepatitis C. Help-4-Hep can also help individuals access lower-cost testing for hepatitis C.
  • Treatment Action Group
    Treatment Action Group collaborates with activists, community members, scientists, governments, and drug companies to make safer, more effective and less toxic treatment for viral hepatitis available.


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This article was provided by National Alliance of State and Territorial AIDS Directors. Visit NASTAD's website to find out more about their activities and publications.
 

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