For consumers who cant afford to pay for medications, the struggle can be literally a matter of life or death.
The good news is, you dont have to go without your meds. Help is available through major drug companies patient assistance programs.
These programs offer free or low-cost drugs to uninsured individuals who cant afford their medications. Most brand-name drugs are found in these programs.
Patient assistance programs have been a godsend for Dallas resident Hobert Haggertys elderly parents, who live on a fixed income. Her father and mother each take several medications a day.
I am so thankful for the program, she said. Its helped because the medications are so expensive $300 or $400 for a 30-day supply gets expensive.
Each drug company has its own rules about who qualifies for its assistance program, but generally, you must be a U.S. citizen or legal resident, have no prescription drug coverage and meet certain income requirements.
Generally, the income criteria will range from 200 percent of the federal poverty level to 400 percent of the federal poverty level, and there are instances where it could be higher, said Tracy Foster, president of Lash Group, which administers patient assistance programs for pharmaceutical firms.
Recipients of Medicares Part D prescription drug benefit arent necessarily disqualified. In fact, most major drug companies have provisions for Medicare patients to qualify, Foster said.
It is sometimes under a special program and may require a special application, she said. It sometimes requires that a patient already have spent a certain amount of money under their Medicare Part D benefit to qualify.
Many of the manufacturers have responded to increasing need by reassessing their income criteria, Foster said. That has helped more patients qualify for assistance.
Over the last three to five years, she said, we have seen manufacturers increase the (income) limit, so theyre accepting patients at higher income levels and acknowledging that there are just greater financial hardships generally speaking, given the economy.
Heres what you need to know about these programs:
TALK TO YOUR DOCTOR
Most of the applications for assistance need doctor participation, Foster said. It will also require a prescription or doctors signature saying the patient is actually being prescribed the medication theyre seeking help for.
DONT RUSH IT
Most programs have income criteria, and you must provide proof of income. Foster said if youve lost your job, include an explanation in your application that says, Heres my previous years tax documentation, but I am currently unemployed.
Read the application instructions carefully and be sure you understand them and follow them precisely.
What can slow down the process sometimes is theres missing information on the application or missing paperwork, Pelletier said.
Some programs are fussy about their applications, according to NeedyMeds, a nonprofit information source that helps people find patient assistance programs.
The directions on the application should be completed exactly as directed, the organization said. Print neatly. If something is unreadable or there is a blank, then the application may be denied, which can delay the process of receiving the medicine. Put N/A or not applicable in blanks that arent filled out to indicate that the material was read through and not skipped over, NeedyMeds said.
PLAN AHEAD: Plan ahead so your medicine supply doesnt run out, NeedyMeds said.
When sending in an application, pay attention to the refill process and the amount of allowable refills, the organization said. Each program is different. Some may require a call from the doctors office, while another may allow the patient to call directly for a refill. Others may require a new application, which takes time.
ASK QUESTIONS
Call the patient assistance program if you have any questions.
Eligibility requirements, drugs, dosages, even programs change regularly, so its best to go directly to the program for information, NeedyMeds said. If you do not qualify for the program but cannot afford the medicine, then tell the representative. Some companies may make hardship exceptions and are willing to review situations on a case-by-case basis.
You can also ask your doctor to write an appeal letter explaining your financial hardship.
So dont let hard times force you to choose between paying for medications and other essentials for your survival. Take advantage of patient assistance programs.
RESOURCES
Here are some sources of information on patient assistance programs and how to contact them:
NeedyMeds is a nonprofit information resource that helps people in need find patient assistance programs. Its a source of information on thousands of programs that may be able to offer assistance to people in need. http://www.needymeds.org.
The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need for free or nearly free. The PPA is sponsored by pharmaceutical research companies. http://www.pparx.com or 1-888-477-2669.
Extra Help is a program provided by Medicare to help those with limited resources and income pay for monthly premiums, annual deductibles and prescription co-payments related to a Medicare prescription drug plan. http://www.ssa.gov/prescriptionhelp/ or 800-633-4227
RxAssist offers a comprehensive database of patient assistance programs and is part of the Center for Primary Care and Prevention at Memorial Hospital of Rhode Island. http://www.rxassist.org.
Rx Outreach is a nonprofit organization that offers prescription medicines to uninsured individuals and families, as well as those who have limited prescription drug coverage. http://www.rxoutreach.org











