www.rxassist.org

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• www.rxassist.org

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Many reasons why people might need assistance

• Ineligible for LIS because of income or asset
  test
• Premium and co-pays might be too high
• Drugs or supplies might not be on plans
  formulary
• Coverage gap or doughnut hole
• Drugs might be prescribed for off label use

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Understand the situation

• Patients can be confused
• Advocates may give wrong information
• Prescribers may be unaware
• Insurers may be unclear

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Basic options for assistance

• Pharmaceutical company patient assistance
  programs
• Discount generic drug programs
• State pharmaceutical assistance programs
• Disease specific assistance programs

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Pharmaceutical company patient assistance programs

• More than half state that Medicare Part D
  enrollees are ineligible for their PAPs
• Only 4 have programs specifically for Part D
  enrollees
• Of those that do allow Part D enrollees to apply
  there is little standardization
• Programs are highly changeable

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Discount generic drug programs

• RxOutreach, Xubex generic PAP programs
• Retail store generic programs
• RxOutreach generics range from 20-40 for 3
  months
• Retail store generics range from 4 for 30 day
  supply to 15 for 3 month supply

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State sponsored prescription assistance programs

• 20 states have wraparound Part D services
• All have income requirements
• Some have age requirements
• Cover all or part of premiums, deductibles,
  co-pays, drugs in doughnut hole, drugs not
  covered by Part D
• 4 states have state-sponsored discount cards

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Disease specific assistance programs

• Non-profit organizations offering financial
  assistance towards co-pays, insurance premiums,
  other out of pocket expenses for specific
  diseases
• Payment models vary
• Certain disease funds may run out of money
• May be waiting lists

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Disease specific assistance programs

• American Kidney Foundation
• Caring Voice Coalition
• Chronic Disease Fund
• Healthwell Foundation
• Patient Access Network
• Patient Advocate Foundation
• Patient Services Incorporated

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Keys to helping patients

• Understand the environments in which prescribers,
  insurers and assistance programs operate
• Familiarize yourself with content of key web
  sites and other sources of information
• Develop or borrow tools to help manage
  information and streamline assistance process

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RxAssist tools

• Database of patient assistance program
  information and applications
• Chart with rx company Part D/PAP eligibility
  policies
• Combined RxOutreach/Xubex generics list
• List of diseases and organizations that provide
  co-pay and other financial assistance for each
• Sources of low cost diabetic and other medical
  supplies
• State specific pharmaceutical assistance programs