Have you ever thought about how much your medication would cost if you didn’t have insurance? Hopefully you won’t be in a position to have to worry about this issue, but for a lot of people the cost of medication is a real barrier to their health. Considering that a recent news article cited approximately 25% of all adults (roughly 48 million individuals) were left without health insurance at some point in 2011, this dilemma of how to pay for medication probably affects more people than you realize. It’s not as though you can tell whether people have insurance just by looking at them – it could be that your friends, neighbors or family members are struggling to pay for medications because they don’t realize that assistance may be available. If you or someone you know is having trouble affording medication, what can you do?
One good first step is to have a straight-forward conversation with your health care provider and pharmacist. Let them know you are looking for the best treatment and also the most cost effective one and that you need their help. They may be able to suggest ways to save money by prescribing a generic medication, using a local pharmacy discount plan, performing a medication review to identify instances where you can take fewer medications, offering education to ensure that all needed medications are being taken in the most effective way, or providing information about Patient Assistance Programs (PAPs).
What is a Patient Assistance Program?
Patient Assistance Programs or PAPs are programs offered by most pharmaceutical companies to provide select name brand products free or discounted to eligible patients. You may have seen television advertisements for medications that say at the end, “If you can’t afford your medication, consult with your healthcare provider.” Medications that are most often provided through PAPs are those that are not available generically or through other pharmacy discount programs. There are varying financial eligibility criteria with most PAP programs targeting the uninsured, although select programs may consider underinsured and total health care expenses when determining eligibility. The applications can be found and completed by individuals on-line or your health care provider may offer assistance in applying for PAP’s – most free clinics offer their patients assistance with medication access (but do not necessarily provide the free/low cost medications) so find out if there’s one near you by going to www.vafreeclinics.org or www.nafcclinics.org. Another good option for medical and pharmacy care are federally qualified health centers which operate on a sliding scale fee structure so you pay a different reasonable amount depending on your situation – find one by entering your zip code at this site www.saveourchcs.org/find-a-health-center-near-you.cfm.
If you meet the eligibility criteria for a PAP and have the necessary income documentation, the medications are typically ordered through the health care provider’s office and will either be mailed to back to the clinic or directly to you. If you know which company makes your medication, more information can be found by going to the manufacturer’s web site, but you can also use one of several web sites that provide comprehensive information on available PAPs (www.needymeds.org, www.rxassist.org, www.pparx.org, etc.).
If you know about these medication access resources and share it with just one other person, you may be able to make a significant difference in someone’s life and impact their long-term health.
Amy Yarcich is the Executive Director of Rx Partnership, a statewide nonprofit dedicated to increasing access to medication for Virginia’s vulnerable populations. The organization has helped over 47,000 Virginians access medications valued at $75 million since the program began in 2004. For more information go to www.RxPartnership.org.