One reason patients do not utilize pharmaceutical assistance is because they simply don’t know that it’s an option. Patients are reluctant to discuss their fiscal constraints with their doctors, missing an opportunity to learn about financial relief programs for medications. If patients don’t know such programs exist, they don’t apply for them.
There are nonprofit organizations whose sole purpose is to connect patients with medication that is otherwise unaffordable. They vet medication assistance programs for which the patient may qualify, and find cost-abating resources to relieve some or all of the prescription price tag.These organizations help patients beyond the cost-burden of their chronic disease; they guide patients through a very stressful, confusing time in which individuals and families may have to choose between their bills and their health.
These organizations include:
- The Patient Advocate Foundation– the PAF hosts a National Financial Resource Directory for patients struggling with medication costs, as well as the other social determinants which cause financial insecurity for patients, such as housing, transportation, food, etc. The PAF isolates financial assistance for insured patients with out of reach deductibles and copays, as well as grants for certain medical procedures and treatments and the nonmedical expenses related to them.
- NeedyMeds– a clearinghouse for patient assistance programs and medication information, they also offer a free drug discount card. Their website assists users in finding information on PAPs and healthcare costs.
- RxAssist– “The Web’s most current and comprehensive directory of Patient Assistance Programs”, their database also keeps information on medication discount cards.
- Partnership for Prescription Assistance– PPA is an industry-sponsored nonprofit which assists uninsured or underinsured patients in finding prescription drug subsidy programs, as well as low or no cost health clinics.
Copay cards and coupons
In addition to PAPs, there are other resources for patients. Some drug companies also disperse copay cards to lower out-of-pocket costs for financially insecure, commercially insured patients with high-deductibles, or expensive coinsurance. Copay cards come in fixed amounts which patients pay towards the prescription. Sometimes companies change the fixed amount their copay card covers, a possible financial shock which patients may not have planned for. A case manager or patient services advocate managing the patient’s prescription assistance might be able to anticipate the new cost-burden for the patient.
In August 2017, New York became the first state to offer a copay program for all insured residents (including Medicare and Medicaid) for Naloxone regardless of prescriptions, in an effort to combat the deadly opioid crisis. The state provides up to $40 copay assistance for the medication which reverses overdose effects. The average copay is $10, but most people pay $0 for the drug. New York City police officers began carrying Naloxone in 2014, trained to auto-inject the medication in cases of emergency. Since that time, the NYPD has administered the drug to over 3,100 citizens, saving 90% of them. Now that New York state has made it easier to get the drug in hands of the people who need it, that number should grow.
Many pharmaceuticals have coupons or rebates (usually for brand-name drugs) to ease the financial strain of consistent medication. Using database’s like NeedyMed can help find offers by searching the prescription. Most consumer drug spend is based on the list price, not the reduced price an insurer or pharmacy may pay. Using the copay coupon can reduce this fiscal burden because of the fixed amount. Consumers can use sites like GoodRx to compare pharmacy costs of medication and find coupons to choose the most strategic place to purchase. If covered by Medicare, Medicaid, or other federal or state insurance programs, patients are ineligible for coupons.
Brands who help their patients obtain the medication they need, diffuse the stress that often accompanies this process, and who find economical solutions, create lasting relationships with their consumers. Companies, patient advocates, and consumers can all agree, getting necessary medication to patients who need it, without creating a monetary strain which would prevent them from adhering to their prescribed regimen, is most important.