New Drug Co-Pay Programs For Patients Initiated By the Fair Pricing Coalition
April 1, 2009
The Fair Pricing Coalition (FPC), which was founded by the late Martin Delaney of Project Inform, is a national coalition of activists who work on HIV drug pricing issues and who help control drug costs, thereby insuring access for recipients of state AIDS Drug Assistance Programs (ADAPs), Medicare and Medicaid, and patients who are privately insured, underinsured and uninsured.
The FPC has recently negotiated patient drug co-pay programs with all major HIV drug manufacturers. The new drug co-pay programs are a direct result of intense work and negotiations between the FPC and representatives of the pharmaceutical industry.
Most, if not all, HIV pharmaceutical companies already provide some level of patient assistance to individuals who are unable to afford their HIV medications. Several companies have also recently instituted co-pay assistance programs, which may cover all or part of the drug co-pay for many privately insured patients, up to a specified amount, and for a pre-determined period of time, for example, ADAP up to one year. Certain restrictions and eligibility requirements apply. For example, ADAP, Medicare and Medicaid patients are ineligible for co-pay programs. Eligibility requirements may vary from program to program. Once eligibility is determined, most companies will provide patients with a co-pay card that can be presented to a pharmacist or a mail order pharmacy when filling your prescription. Since the FPC expects the launch of new programs and revisions in current programs as negotiations continue, patients should contact or ask their health care providers or pharmacies to contact drug manufacturers directly for updated details on a specific drug.
There are may also be medications in addition to HIV drugs that individuals require, such as prescription medicines to control other conditions such as high cholesterol or diabetes. To find patient assistance or drug co-pay programs for these and other types of drugs, visit http://www.needymeds.com.
Together Rx is a prescription savings program for uninsured individuals sponsored by many of the nation's leading pharmaceutical companies. For more information call toll-free 1-800-966-0407, or enroll online at www.TogetherRxAccess.com.
Below is a brief description on the availability of most HIV drug co-pay programs. Residents of Massachusetts are ineligible for these co-pay programs unless no part of the cost of their prescription is covered by insurance. A company program chart listing further details is provided below. Drug companies are often secretive about patient assistance programs (PAPs) and co-pay programs. Many will not volunteer information in an effort to avoid providing patients with free drugs, co-pay assistance orother financial services. Remember, if you are persistent enough many companies will often make exceptions to the criteria listed. You may even be granted full PAP eligibility. Even if you think you are not eligible, call the program anyway to make inquiries.
Abbott: Positive Partnership PLUS Card -- Abbott recently launched a pilot program that expands the Positive Partnership Card. This 12 month program covers Kaletra plus other ARVs and requires no income or co-pay eligibility requirements. Your first out of pocket dollar will be covered up to a maximum of $50 for Kaletra each month. Abbott will also cover another $50 monthly for each additional HIV prescription up to a limit of $100 monthly. The FPC is extremley disappointed that Norvir is currently not covered in this program. Visit www.kaletra.com for more information.
Bristol-Myers Squibb (BMS) recently announced that they will be launching a co-pay program in April of 2009. Their program will include Reyataz and Sustiva. More details will be provided as they become available. We hope Atripla, the one pill once a day, which BMS comanufacturers with Gilead will be covered in the BMS program.
GlaxoSmithKline (GSK): Patient Savings Card -- The GSK program is the most patientfriendly, covering the entire amount of all your actual out-of-pocket cost up to a maximum of $100 for each prescription. All GSK HIV drugs are covered, including Combivir, Epivir, Epzicom, Lexiva, Retrovir, Trizivir, and Ziagen. Visit www.mysupportcard.com for more information and to print the card.
Gilead: Truvada Co-pay Assistance Program -- Gilead's program covers Truvada, Emtriva, and Viread. This program covers high co-pays and kicks in only once patients have spent over $50 in out-of-pocket costs and covers a maximum of $200 in co-pays per month. Patients or providers can call toll-free 1-888-358-0398 to receive an eligibility card from Gilead by mail. Atripla is currently not part of this program.
Merck: Unfortunately, Merck does not have a specific insurance co-pay assistance program. However, it does have a patient assistance program (PAP) for Isentress and Crixivan called "Support." If patients need co-pay assistance for Crixivan or Isentress they need to use the "Support" program. Call 1-800-850-3430, or visit www.isentress.com, click on the site map, and then click "Support." Some patients have experienced difficulty in accessing the co-pay aspect of this program. Be sure you clarify that you are applying for co-pay assistance, not for the PAP program. The eligibility criteria are different for each program.
Pfizer: The FPC is disappointed that Pfizer does not offer co-pay assistance for HIV medications. However, it does provide reimbursement assistance, appeals assistance, and patient assistance for Selzentry, Viracept and Rescriptor. Pfizer also offers information on obtaining assistance with tropism testing. Call the Pfizer RSVP program at 1-888-327-RSVP (7787) M?F, 9:00 am ? 8:00 pm Eastern Time; fax 1-888-773-0121, or write to Pfizer RSVP, PO Box 220574, Charlotte, NC. 28222-0574. For assistance with all other Pfizer medicines, call Pfizer Helpful Answers (PHA) at 1-866-706-2400, or visit www.pfizerhelpfulanswers.com.
Tibotec: Tibotec Therapeutics Patient Savings Program -- Tibotec covers Prezista and Intelence. This program covers 80% of the amount of your actual out-of-pocket cost up to $100 per drug per month. Visit www.prezista.com/prezista/patient_assistance.html or call toll-free 1-866-961-7169.
For more information, please call the Project Inform Hotline at 1-800-822-7422.
This article was provided by Fair Pricing Coalition. Visit FPC's website to find out more about their activities and publications.
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