For too many Americans, skipping doses of prescription drugs to save money or cutting pills in half to make them last longer is a way of life.
More than half (54 percent) of Americans say they currently take prescription medicines, and the slowing economy has some patients on the verge of a medical crisis. According to a March 2008 report, "The Public on Prescription Drugs and Pharmaceutical Companies," issued jointly by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health, one in five Americans are currently taking four or more prescription drugs on a daily basis.
The uninsured pay more for prescriptions
Adding insult to injury, those without insurance actually pay more for prescription drugs than many others.
Researchers from state Public Interest Research Groups (PIRGs) posed as uninsured Americans in July 2006 and phoned more than 600 pharmacies in 35 cities to see how much uninsured customers would pay for 10 common prescriptions. They then compared the prices with what the pharmaceutical companies charge the federal government for those same drugs and what they cost at a Canadian pharmacy. The survey examined the drugs most commonly used by people under the age of 65, such as antibiotics, allergy medication, anti-depressants, and cholesterol-lowering medication.
The investigation found that uninsured Americans pay 65 percent more on average than what the federal government pays. Uninsured patients in the Northeast pay the highest prices for the 10 drugs.
Nationwide, the cities with the highest prices were Boston, Sacramento, San Francisco and Hartford.
Uninsured patients pay twice as much as what they would pay at a Canadian pharmacy.
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The report shows that a significant portion of those with prescriptions have difficulty affording them. Four in 10 adults (41 percent) say it is at least somewhat of a problem for their family to pay for prescription drugs they need, including 16 percent who say it is a serious problem. That leads to personal strategies for cutting back: Three in 10 (29 percent) say that they have not filled a prescription because of the cost in the last two years, and 23 percent say they have cut pills in half or skipped doses in order to make medication last longer.
Four in 10 report at least one of these three problems (a serious
problem paying for drugs, not filling a prescription because of cost, and/or skipping doses in the past two years). These percentages swell even more among those who take larger numbers of prescription drugs, those who don't have prescription drug insurance and those with lower incomes, according to the report.
Pharmaceutical manufacturers are well aware of the problems of affordability of their products, and know that public perception is against them. Seven in 10 Americans say pharmaceutical companies are too concerned about making profits and not concerned enough about helping people.
Most drug manufacturers do offer help to people who can't afford their prescriptions. The companies provide medications for free or at a reduced cost to people who qualify for their patient assistance programs. There are hundreds of these programs and many drug makers operate multiple programs, depending on the medicines involved.
Eligibility rules for patient assistance programs vary considerably, but often you must be without insurance coverage for prescription drugs (including Medicaid and Medicare), meet low-income guidelines and be unable to afford your medicine on your own.
While many people report problems paying for drugs, according to the USA Today report, there is awareness of these patient assistance programs. Nearly six in 10 adults (58 percent) have heard of these programs, but 65 percent of those who have heard of them think the programs don't go far enough to help people. However, 16 percent say that they or someone in their family has applied for discount or free medications from a pharmaceutical company in the past.
If you can't afford to pay for your prescriptions and you're thinking of applying to a drug maker for assistance, first find out who manufactures the medication you take. If it's not listed on your prescription bottle, check with your pharmacist or doctor. Then locate a potential assistance program; resources for doing so are listed below. You may have to get your doctor involved: He will likely have to sign applications for assistance.
How you obtain the required forms can vary. You might call the drug makers yourself and request applications directly through their patient assistance programs. Some manufacturers prefer to communicate directly with a physician, social worker or patient advocate.
Finding patient assistance programs
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The Access Project
(800) 734-7104
The Access Project's goal is to help you find a assistance in some form, whether it's Medicaid, Medicare Part D, a state program, a drug company's patient assistance program, private insurance, or even a clinical trial. The site also has information on AIDS Drug Assistance Programs across the nation. ADAPs provide a number of different drugs, free to low cost to AIDS/HIV patients.
Free Medicine Program
Volunteers will help you find a suitable patient assistance program and help you apply, including sending you an application kit with a letter for your doctor to fill out for the drug company. There is a $5 processing fee for each medication, which is refunded if you don't qualify. If you do qualify, you will receive a 90-day supply of your medicine sent to your home within two to three weeks by the drug maker. To qualify you must meet the following requirements:
- You do not currently have insurance coverage for outpatient prescription medicines.
- You have an income level that causes hardship when prescription medicines are purchased at retail price.
- You do not qualify for a government or third-party program that provides for prescription medicine coverage.
National Organization for Rare Disorders (NORD)
(203) 744-0100
NORD works in conjunction with drug makers to offer free-medication assistance, including drugs to treat multiple sclerosis, Hodgkins lymphoma, narcolepsy, Crohns disease and many others. NORD administers the patient assistance programs for numerous medications. The Web site lists each program's separate contact information.
NeedyMeds.com
NeedyMeds.com tracks patient assistance programs with lists by drug, manufacturer and program. There are also lists by state of programs that will help you with the paperwork, plus information on disease-based assistance and drug discount cards. There is no phone helpline.
Partnership for Prescription Assistance (888) 477-2669
The Web site helps you determine what assistance programs you may be eligible for by clicking on your medications and filling out a short eligibility form. PPARx also has online forms for doctors to use for patient applications.
RxAssist.org (401) 729-3284
RxAssist offers a database of patient assistance programs. You first register by answering a few questions, then you can search by drug name or by pharmaceutical company to locate programs.
Single Patient Investigational New Drug Program by the Food and Drug Administration (FDA)
Patients who are in medical crisis may receive drugs that are not yet FDA-approved by having their doctor apply to the program. This program is for "emergency" or "compassionate" prescriptions. Doctors must first get permission from the drug manufacturer.
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People suffering from AIDS/HIV often have serious financial problems, especially since many do not have private insurance, are too sick to work and require costly drug cocktails to prolong their lives. AIDS/HIV drugs can range from $800 a month for 30 pills to well into the thousands for certain protease inhibitors, and very few antiretroviral drugs are available on the generic market.
There are programs like The Access Project's AIDS Drug Assistance Program (ADAP) that help those in dire circumstances. Dr. Margaret Hoffman-Terry of the American Academy of HIV Medicine says that patients who forgo medication in order to pay for rent, gas and groceries are a growing problem.
"I have a patient who is taking a number of medications for HIV, but also cholesterol medication because she is in the high-risk category for a heart attack," says Hoffman-Terry. "She has been faced with the choice of choosing her HIV medication over the other medications she needs to maintain her heart condition. This situation has become common with many of my patients."
Patients who forgo medication in order to pay for rent, gas and groceries are a growing problem.
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Some pharmaceutical companies have a co-pay program for HIV drugs, but according to Hoffman-Terry there are very few drug companies that have a program in place.
"Paying a $2 to $3 co-pay per script doesn't seem like a lot, but when it comes to people who are on public assistance and are unable to work and they receive a check for $500 and have $400 in rent, and have several drugs that they need to stay healthy, it's an enormous problem," she says.
If you aren't eligible for a patient assistance program, don't give up hope. There are other ways to lower your prescription drug costs. Some companies market drug-discount cards that entitle you to breaks on prescription prices. In addition, major store chains offer low flat-rate prices for generic prescription drugs: Wal-Mart and Target have lists of prescriptions available for $4. In February 2008, Kroger Pharmacies began their own $4 drug progam and in June 2008, Safeway became the first grocer to offer the same discount for prescription drugs.
Also, ask your doctor for free samples of any drugs prescribed. Most physicians have closets full of them.
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