Medication Costs Stopping You From Getting What You Need? Apply for PAP Programs!
Sections:
- Understanding Patient Assistance Programs
- Eligibility Guidelines
- PAP Programs Available
- Step-by-Step Application Process
- Advice
What are PAPs?
Patient Assistance Programs (PAP) are programs typically managed by pharmaceutical companies to allow underinsured or uninsured individuals get access to otherwise unaffordable medication. PAPs can either cover the full cost of the medication or provide a discount.
However, PAPs are difficult to apply to without receiving assistance and documentation from your care team. Their eligibility criteria and process for applying can be difficult to understand and follow up on. Additionally, there is limited data about how many people have received assistance from PAPs.
Despite the lack of data, from my own personal experiences as a patient advocate, the patients I have worked with in the past have had success in applying and receiving assistance from various PAP programs. But applying to PAP programs requires a great deal of patience, perseverance, and collaboration between the patient and the care team (social worker, primary care physician, patient advocate, etc). This guide will help you create a plan for applying to various PAPs and how to involve your care team.
Eligibility Guidelines
Because each PAP is run by each pharmaceutical company, they have different eligibility requirements. However, some common eligibility requirements are
- Be a U.S. citizen
- Are underinsured/uninsured
- Under income guidelines for specific program
However, due to the number of PAP programs, there is a lot of variation in the eligibility guidelines and you should visit each program’s website for further information.
PAP Programs Available
There are many PAP programs out there due to the number of pharmaceutical companies. Fortunately, there is a website that you can use to search through a database of PAP programs. Visit www.rxassist.org/patients. You can look for appropriate PAP programs that could help you receive medication based on the medication name or the pharmaceutical company name.
Suppose I was in need of receiving Ensure. I searched for Ensure under “Search by Drug”. I get directed to this page.
From here I click on the hyperlink “Ensure Plus” and this page will have all the relevant info regarding the eligibility and contact information for the PAP program. I would recommend navigating to the program website for the official information of the program. You can find the link to the program website here:
According to GoodRx, some common medications are
- Gilead Advancing Access Program
- GSK Patient Assistance Program
- Healthwell Foundation
- PAN Foundation
- Lilly Cares Foundation Patient Assistance Program
- Novartis Patient Assistance Foundation
- Novo Patient Assistance Program
- Pfizer Patient Assistance Program
Step-by-Step Application Process
Now that you have found the program website for the PAP program, it’s time to make a plan on how to apply for the program. From the example above, let’s say that we want to apply for the Ensure PAP. We have navigated to the Ensure PAP program website: Ensure, Here, the program outlines the specific steps to apply along with the specific forms needed for each medication: Ensure PAP Program.
Advice
- It is a good idea to gather all documentation and fill out everything on your end before handing it off to your care team for them to complete their part of the application.
- Ask your care team personnel how long they think it will take to submit the application. Follow up on the progress of the application once you hand it off to members of your care team.
- Once the application is submitted to the company (which could be done via mail, email, fax depending on program guidelines), call the company to make sure they received the application.
- Check voicemails, messages, or mail regarding documentation requests or requests for additional information.
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