As a specialty pharmacy provider, we review the patient’s reimbursement situation and offer financial assistance options to those on high-cost medications.

We help connect each patient with assistance solutions for affordable treatment options.

Copayment Assistance Programs:

• Also called a manufacturer copay card, may be available to patients who have prescription insurance.
• May be offered in the form of a rebate, coupon, or copayment card directly from the manufacturer.
• Manufacturer programs are typically offered to all patients, are not usually need based, and do not usually require an application process.
• Policies on whether or not these programs can be used in conjunction with a patient’s government-sponsored plan vary, and most do not include patients who receive Medicare, Medicaid, or Tricare.

Company-Specific Patient Assistance Programs:

• Patient Assistance Programs (PAPs) are programs set up voluntarily by pharmaceutical companies to offer free or low-cost drugs to primarily uninsured patients who cannot afford their medication.
• Each program has its own rules, patients must typically be US residents, have no prescription insurance, and be under 200% of the federal poverty level as certified by the physician or required documentation.
• Companies vary on whether or not they allow Medicare and other government-insured patients to enroll in these programs.

Disease-Based Patient Assistance Programs:

• Funds are usually administered through a not-for-profit group that can evaluate a patient application based on financial need.
• Funds and foundations typically deal with medications and diseases that are expected to have significant out-of-pocket expenses (often thousands of dollars per month) associated with them.
• Programs can assist patients who are having a difficult time paying for the deductible, coinsurance, or copayments.
• Pharmaceutical companies often fund these programs, but are not involved in evaluating whether or not the patient meets the pre-specified program requirements.

(Reference: http://www.pharmacytimes.com/publications/specialty-pt/2011/May2011/Medication-Financial-Assistance-Programs)