Financial Assistance for Rheumatoid Arthritis Medicationsby Lisa Emrich Patient Advocate
It’s often not easy to find financial assistance to pay for expensive medications for rheumatoid arthritis (RA). But if you know where to look, there are a number of programs and services that can help you.
Many of the pharmaceutical companies that produce drugs specifically for the treatment of RA make financial assistance available to patients in need. This benefits the patient and the drug company. Face it, they want you to continue to use their medication and not move to the competition, which might have better assistance available.
Often each company will run their own program or make contributions to independent foundations that handle the administration of "free medication" or copayment assistance. Also, don’t forget about sources of lower cost generic drugs and/or drug coupon programs.
This post is long, so keep scrolling through until you find your drug and/or the appropriate assistance program for youIf you don’t know where you stand in relation to the Federal Poverty Level (FPL), use the U.S. Department of Health & Human Services poverty guidelines.
1. ASSISTANCE FROM THE MANUFACTURER
Abatacept (Orencia) The Bristol-Myers Squibb Patient Assistance Foundation provides medication at no or low cost on a temporary basis to people in financial need who do not have insurance. There are a number of additional eligibility requirements be found on the Foundation website.
Patient Assistance Foundation, Inc.
PO Box 220769
Charlotte, NC 28222-0769
Adalimumab (Humira) The Humira Protection Plan helps patients access Humira. If you are unemployed and uninsured, you may be able to get Humira at no cost to you through AbbVie Patient Assistance Foundation. If you are covered by Medicare Part D, you may be able to get help from an independent co-pay foundation.
If you are employed with prescription coverage, you can reduce your co-pay to $5 per month. However, this copay assistance program is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs, or private insurance in the Commonwealth of Massachusetts. Monthly co-pay assistance amounts are subject to predetermined limits.
Phone: 1-800-4HUMIRA (1-800-448-6472) for reimbursement assistance
HUMIRA Program website.
AbbVie Patient Assistance Foundation - HUMIRA Patient Assistance Program
P.O. Box 789, San Bruno, CA 94066
Phone: (800) 222-6885 for uninsured or underinsured assistance
Fax: (866) 250-2803
AbbVie Patient Assistance Application Form.
Anakinra (Kineret) The Kineret OnTrack Support Program helps to verify insurance coverage and provides temporary product assistance to financially needy patients who meet predetermined eligibility criteria. To receive free product, the prescriber and patient must complete a Kineret Patient Assistance Program Application.
P.O. Box 83396
Certolizumab pego (Cimzia)
The CIMplicity program provides a variety of services. This includes the CIMZIA $0 Co-Pay Savings Card, with a maximum annual benefit of $11,000. People who are in receipt of Medicare or Medicaid, or other public payer are not eligible.
CIMplicity also provides help with insurance, both in terms of coordinating requirements for private insurance, and guidance to find independent foundations for those who are on Medicare or Medicaid. People who are not insured may get help through the Patient Assistance Program. For more information on how to access help in all three categories of insurance coverage, see the CIMplicity insurance page.
Phone: 1-866-4-CIMZIA (1-866-424-6942)
Etanercept (Enbrel) The ENBREL Support™ Copay Program lowers costs for eligible patients. The program may offer 6 months at no copay cost to you, and $10 or less copay per month thereafter. Eligibility may vary, depending on whether you have insurance on Medicaid or Medicare. The program offers help from their Medicare Solution Specialists to determine other sources of assistance.
Phone: (888) 4-ENBREL or (888) 436-2735 for reimbursement assistance
Program website: http://enbrelsupport.com/
If you have no insurance coverage or are underinsured, you may be referred to the Safety Net Foundation, a nonprofit foundation support by Amgen, and you may qualify to receive Enbrel at no cost. If you are insured but still need more financial assistance, you may be referred to an independent foundation.
The Safety Net Foundation
P.O. Box 18769
Louisville, KY 40261-7821
Phone: 1-888-762-6436 for uninsured or underinsured assistance
Safety Net Foundation Application form
SimponiOne® Support provides medication assistance for people who have insurance. Enrolment enables you to pay $5 per Simponi injection, up to an annual maximum benefit of $20,000. If you receive any state or federal government services, such as Medicaid or Medicare, you will not be eligible, but SimponiOne can help direct you to independent foundations that may be able to assist.
Phone: 877-MY SIMPONI (877-697-4676)
If you have been prescribed Simponi, but have no insurance, Janssen Prescription Assistance may be able to help you find prescription assistance.
Infliximab (Remicade), There are ten programs which provide various levels and kinds of assistance for Remicade based on receipt of insurance, Medicare or Medicaid. Some are affiliated with Janssen, the makers of Remicade, many are not. Janssen’s listing of assistance programs is updated frequently.
The RemiStart program will be able to assist you in determining your eligibility for the different programs.
See additional information on the NeedyMeds Remicade page.
Rituximab (Rituxan) Genentech Access Solutions, provided by Genentech Access to Care Foundation, provides a variety of assistance in helping you get coverage for Rituxan. This can include benefits investigation to help you understand your insurance coverage. As well, commercially insured individuals may be eligible for a co-pay card with up to $10,000 in co-pay assistance per 12 months, under which eligible patients would pay $5 per co-pay. People who meet certain financial and medical criteria may also qualify to receive Rituxan free of charge. Assistance with connecting to independent foundations is also available.
1 DNA Way, Mail Stop #858a
South San Francisco, CA 94080-4990
Enrollment, authorization, and other forms are also available on NeedyMeds Rituxan page.
There are three programs that can help with various aspects of receiving Actemra.
The Genetech Rheumatology Co-Pay Card Program enables eligible people to pay $5 per drug co-pay, with an annual maximum of $10,000. This is available for individuals who have commercial insurance or who pay by cash. Patients can determine eligibility on the Actemra website or by phone.
The ACT Fast Program may provide Actemra for free up to six months while waiting for your health plan provider to decide whether or not to cover the medication.
Genetech Rheumatology Access Solutions provides assistance in helping to guide patients through getting their medication and connecting them with patient assistance programs.
Phone: 1-800-ACTEMRA (1-800-228-3672)
The XELSOURCE program provides assistance with financial aspects of taking Zeljanz.
There is also a co-pay savings card for individuals with private insurance. Eligible patients may receive Xeljanz with a $0 copayment, with a maximum annual benefit of $8,000. The co-pay card can be used at participating pharmacies. If your pharmacy does not participate in this program, you can obtain a rebate from XELSOURCE.
Patients who have government insurance, such as Medicare or Medicaid, can receive assistance in locating private foundations for financial help.
Individuals who do not have insurance may qualify for Hardship Assistance through the Xeljanz Patient Assistance Program.
Eligible individuals may also receive a free two-week trial prescription of Xeljanz. This should be requested by your doctor.
Phone: 1-855-4-XELJANZ (1-855-493-5526), select option 4.
Assistance with Other Medications
Leflunomide (Arava) Patient Access Network Foundation
The program offers assistance to individuals in receipt of for Medicare. At this time, they are no longer accepting applications for new or renewal patients. This status may change.
Phone: 888-316-PANF (7263)
Mycophenolate mofetil (CellCept) The CellCept co-pay card can reduce your out-of-pocket costs to $15 per prescription a refill, and offers an annual benefit of up to $5000. You must be commercially insured in order to be eligible for this card, but there are no income requirements.
Phone: 855-SAV-CELL (855-728-2355)
The Genentech Access to Care Foundation (GACF) helps people who are uninsured or underinsured. If you qualify for GACF, you may get your medication free of charge.
Genentech Access Solutions, provided by Genentech Access to Care Foundation
1 DNA Way, Mail Stop #858a
South San Francisco, CA 94080-4990
Phone: (866) 422-2377
Enrollment, authorization, and other forms are also available on NeedyMeds CellCept page.
Cyclosporine (Neoral) Novartis Patient Assistance foundation, Inc.
This program provides assistance through the Patient Assistance NOW program if you do not have third-party insurance, including Medicare and Medicaid.
Minocycline (Minocin, Dynacin) RxOutreach Medications
Application forms are located on the program website or on the NeedyMeds site.
Indomethacin (Indocin, Indocin SR) Patient Access Network Foundation (PAN)
PO Box 221858
Charlotte, NC 28222-1858
Phone: 866-316-PANF (7263)
Application forms also available on NeedyMeds Indocin page.
Chlorambucil (Leukeran) Patient Access Network Foundation (PAN)
PO Box 221858
Charlotte, NC 28222-1858
Phone: 866-316-PANF (7263)
Application forms also available on NeedyMeds Leukeran page.
Oxycodone (OxyContin, Roxicodone, OxyFAST, OxyIR (liquid)) Purdue Patient Assistance Program
This program provides assistance to people who will low-income individuals who have no drug coverage, and who qualify.
Purdue Patient Assistance Program
P.O. Box 66547
St. Louis, MO 63166-6547
Phone: (800) 599-6070
The OxyContin Savings Card allows eligible individuals can up to $70 per prescription. To learn more about the OxyContin Savings Card, call 1-800-615-4987
Pfizer RxPathways Patient Assistance Program
Covered medications include:
Diclofenac sodium with misoprostol (Arthrotec)
Sulfasalazine (Azulfidine, Azulfidine EN-Tabs)
Rx Outreach Medications
PO Box 66536
St Louis, MO 63166-6536
The program provides medications at low cost. You must be a US resident at or below 300% of Federal Poverty Level. Recipients can include those who are insured, or in receipt of Medicare Part D.
2. ASSISTANCE FROM COPAYMENT FOUNDATIONS
A copayment is the amount an insured patient must pay for a prescription drug or an office visit at the time of service. It is part of the cost-sharing arrangement with the health insurance company and varies depending upon the specifics of coverage. Patients who have private insurance coverage or a Medicare Part D plan, but still can’t afford the copays or deductibles for the expensive medications they need, are considered UNDERINSURED.
Since 2003, a number of independent, charitable organizations have been established to assist the underinsured patient in meeting this specific financial need. The drug companies make contributions to each organization which then independently administer the assistance to medically and financially qualified patients according to their own criteria and resources.
Each of the following non-profit organizations maintain segregated disease funds, including ones for rheumatoid arthritis, from which awards are made. When the resources of a particular fund become too low, applications will not be accepted until sufficient funds become available. This means that you may need to bounce back-and-forth between organizations looking for assistance and may even have to wait until a program opens up to new or renewing patients.
Patient Access Network Foundation (PANF) To qualify, the person must receive Medicare and Medicare must cover the medication for which they need assistance. The medication must fight the disease directly. Patient must live and received treatment in the US. Patient’s family income must fall below 400% Federal Poverty Level.
Patient Access Network Foundation
P.O. Box 221858, Charlotte, NC 28222
Phone: (866) 316-PANF or (866) 316-7263
Patient Advocate Foundation (PAF) Co-Pay Relief Program The Patient Advocate Foundation (PAF) Co-Pay Relief Program provides assistance to individuals with a confirmed diagnosis of chronic pain. The individual should have insurance, and the insurance must cover the drug for which assistance is being sought. The person should live and be treated in the US.
You can register online if you have a valid email address.
Patient Advocate Foundation
Co-Pay Relief Program
421 Butler Farm Road
Hampton, Virginia 23666
Toll Free 1-866-512-3861 Local: 757-952-0118 Fax: 757-952-011. SOURCES OF LOWER COST GENERIC DRUGx Outreach Rx Outreach is managed by Express Scripts Specialty Distribution Services, Inc. (ESSDS), a fully-licensed mail order pharmacy that is committed to making the use of prescription drugs safer and more affordable. Rx Outreach is not a prescription insurance program nor an Internet pharmacy. The program offers prescription medicines to individuals, both those who are not insured, and those who are, including Medicare and Medicare Part D. Eligibility is determined by family size and income, which must be below 300% Federal Poverty Level.
The cost to fill a prescription depends on the medication and the quantity you need. Prices can be found on the Rx Outreach medication list. The price listed is for any dose or strength. There is no membership fee required to use Rx Outreach. his is my favorite low-cost program available for generic medications.**
Rx Outreach, Express Scripts Specialty Distribution Services, Inc.
P.O. Box 66536, St. Louis, MO 63166-6536
Phone: 1-888-RXO-1234 (1-888-796-1234)
learn more on the RxOutreach program website.
Generic drug programs are also available at:
4. DRUG COUPON PROGRAMS
Many drugs have coupons available from the manufacturer that enables you to purchase it at a reduced cost. To check if your medication has a coupon offer, check the NeedyMeds listing for medication coupons and rebates. You may also wish to talk to your pharmacist, as they are often very knowledgeable about this.
Although this post may have seen to present an exhaustive list of programs, there are other programs available. Janssen’s list of resources is updated on a regular basis. As well, the website NeedyMeds is a great resource for staying up-to-date on medications and the agencies and foundations that may provide assistance.