costs and insurance

Beginner's Guide to MS: Need Help Paying Drug Bills?

Lisa Emrich Health Guide October 10, 2008
  • So you’ve been diagnosed with multiple sclerosis and your doctor has prescribed some very expensive medication.  You have no insurance, limited prescription coverage, or high co-payment requirements, and are a U.S. resident. 

    What do you do?
      Call the support program for the drug of your choice.

    Most pharmaceutical companies have assistance programs which help patients obtain their medication at a reduced cost.  The drug companies really want you to use their medications, so they have programs set up to navigate insurance coverage, maximize reimbursement, and lower out-of-pocket costs for the patient so that they gain market share.


    To find available programs for any disease or medication, start with Needy Meds or Rx Assist.  Both of these resources list available programs by drug name and by disease category. 

    For generic medications, consider the $4 programs at stores such as Walmart or Target.  Or for mail-order and a most extensive list of generic medications, check Rx Outreach http://rxoutreach.org/ which just recently raised the rates on their service.

    Providing co-payment assistance to insured patients are Patient Access Network Foundation (PANF) and Chronic Disease Fund (CDF).  PANF specifies an income limit of 300% Federal Poverty Level (2008 FPL Guidelines) while CDF’s income requirements are undisclosed.  The maximum award from PANF is $4000.  Listed drugs include Avonex, Betaseron, Copaxone, Rebif, Tysabri (CDF only).

    National Organization for Rare Disorders, NORD offers the MS Premium Co-Pay Assistance Program which has a $5400 maximum award toward only approved medications.


    Copaxone Patient Assistance Program
    - Call Shared Solutions at 1-800-887-8100

    Betaseron Patient Assistance Program - Call BetaPlus at 1-800-778-1467

    Rebif Patient Assistance Program
    - Call MS LifeLines Access Made Simple at 1-877-447-3243

    Avonex
    and Tysabri Access Programs - Call MS Active Source at 1-800-456-2255

    The following programs do not have MS-related funds: Co-Pay Relief Fund, Patient Advocate Foundation, Patient Services Incorporated, HealthWell Foundation.

     

    For assistance in receiving generic medications at a reasonable price, check out the program at Rx Outreach.  A program I've come to use regularly.

     

    I’m curious.  How do you pay for your meds?  Do you need or receive assistance?  Please share your story.

     

    Lisa Emrich is author of the blog Brass and Ivory: Life with MS and RA and founder of the Carnival of MS Bloggers.