March 15, 2005

There's another option. I'm going to turn my bully pulpit over to another expert today - one who deserves a lot of credit and our thanks for trying to help an impossible situation.

Without further ado, here's our guest columnist, Dr. Sagall:

Pharmaceutical Companies Helping Patients Get Their Medicines

By Richard J. Sagall, M.D.

It’s a choice no one should have to make – pay rent and buy food or get prescriptions filled. Yet all to often it's a choice Americans, particularly older Americans, have to make.

Over 40 million Americans have no health insurance, and millions more have limited coverage. Many Americans just can’t afford health care, and, if they can, they don’t have the money to buy their medicines.

Patient Assistance Programs

There is help available for many people who can’t afford their medicines. These programs, frequently called patient assistance programs (PAPs), are designed to help those in need obtain their medicines at no cost or very low cost.

Many, but not all, pharmaceutical companies have PAPs. The manufacturers who have programs do so for various reasons. Some believe that they have a corporate social obligation to help those who can’t afford their products. Others believe it’s a good marketing tool. As one PAP director once told me, many people who can’t afford their medicines now go on to obtain some type
of coverage. And when they get this coverage, the companies want the patient to remain on their products.

Last year, PAPs helped over 5 million people. The programs filled 14.1 million prescriptions with a total wholesale value of over $2.3 billion.

The Basics of the Programs

All PAPs are designed to help those in need obtain their medicines. Since each pharmaceutical company establishes its own rules and guidelines, all are different. All have income guidelines – but they vary considerably. Each company selects which drugs are available on their programs and how long a
person can receive assistance.

How PAPs Work

Although no two programs are exactly the same, most require that the applicant complete an application form. The amount of information required varies. Some programs require detailed medical and financial information, others very little. All require a doctor’s signature. Certain programs require the doctor complete a portion of the form while others only need a signed prescription.

Most send the medicines to the doctor’s office for distribution to patients, while others send the medicine to a pharmacy. A few send a certificate the patient gives to the pharmacist.

Some patients need drugs for a long time. Most programs that cover medicines used to treat chronic diseases offer refills, but not all programs.

What Medicines Are Covered

The pharmaceutical companies decide if they will have a PAP and, if they do, which of their medicines are available through the program. Some include many or all of the medicines they make while others include only a few. The reasons for their decisions are not something they reveal. None include generic medicines in their programs.

Sometimes a medicine or a certain dosage of that medicine will be on a program, then off, and then back on again. Or one dose of the medicine will be on the program while a different dose won’t be.

How To Learn About PAPs

Your doctor is not the best source of information on PAPs. Surprisingly, many doctors don’t even know PAPs exist. The same applies for pharmacists. Many social workers know about the programs. Any books in the library on PAPs are probably outdated before they are printed.

The best place to learn about PAPs is the Internet. There are a number of sites that have information on these programs. Many pharmaceutical companies have information on their patient assistant programs on their websites. Unfortunately, it’s often hard to find the page that describes their PAP.

Types of Websites

There are two types of websites with information on patient assistance programs. Three sites list information on patient assistance programs - NeedyMeds (http://www.needymeds.com), RxAssist (http://www.rxassist.org), and HelpingPatients.org (http://www.helpingpatients.org). There is no charge to use the information. These sites don’t have a program of their own nor do they help people get their medicines.

NeedyMeds is self–funded by sales of manuals and other items. The Robert Wood Johnson Foundation supports RxAssist. The Pharmaceutical Research and Manufacturers of America (PhRMA), an association and lobbying group whose members include many of the larger pharmaceutical manufacturers,
runs HelpingPatients.org, It only has information on PhRMA members programs.

Then there are a number of sites that charge to help people learn about patient assistance programs and complete the application forms. The charges vary, as does the quality of their services. Some offer a money-back guarantee if they can’t get your medicines.

How To Use NeedyMeds

I will describe how to use the NeedyMeds site – the one I know most about. RxAssist and HelpingPatients contain similar information.

There are two ways you can check to see if your medicines are available on a patient assistance program. One is to click on the drug list. This brings up an alphabetical list of all the drugs currently on PAPs. Find the medicine you take and click on its name. This will bring up the program page.

On the program page you will learn about the specifics of the PAP – the qualification guidelines, the application process, the information you need to supply, what your doctor must complete, etc. In addition, you will learn if there’s a downloadable application on the website or if you must get an application from the company. (Some companies accept copies of their application form while others require you complete an original.)

If you know the medicine’s manufacturer, you can click on the programs list. From there, you can click on the program you want to learn more about. That should bring up the information you need.

Once you get the information you need, it’s up to you to complete the applications, get the necessary signatures, and send the form to the program.

A Few Tips

The most common problem patients encounter when completing the application forms is lack of physician cooperation. Over and over I hear from people whose physicians just won’t complete the forms – or charge to do it.
I am asked what they should do.

Here are a couple of suggestions:

1. Make sure you have completed everything on the form you can. Not only should you complete the applicant’s section, but anything else you can do. This may include the physician’s name and address, phone number, etc.

2. Bring all the information your doctor may need. For example, some programs require proof of income. If so, attach whatever documents are required.

3. Bring an addressed envelope with the appropriate postage.

4. Don’t expect your doctor to complete the form immediately. A busy doctor may not have time to read the form while you are in the office.

5. If you encounter resistance, tell your doctor that without his/her help, you wont be able to obtain the medicines he/she is prescribing. Be blunt.

6. If all else fails, you may need to find a physician more sympathetic to your plight and willing to help you.

What If I Don’t Have A Computer?

Many people without a computer can still use the information available on these websites. Nearly everyone knows someone with a computer – a family member, a neighbor, or a friend. Most public libraries have computers for public use and people who can help those not familiar with their use.

Summary

Patient assistance programs are not the best solution to the problem of inability to pay for medication. However, it is the best solution for some people. Millions of people use PAPs to get the medicines they need but can’t afford. If you can’t afford your medicines, a patient assistance program may be able to help you.

* * *

Richard J. Sagall, M.D., is a board certified family physician. He co-founded NeedyMeds and continues to run the site. He can be reached via the website, http://www.needymeds.com. Currently he practices occupational medicine in the Philadelphia area.

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Progress might have been all right once, but it's gone on too long.
-- Ogden Nash


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Is It A Stroke?

Would you be able to identify the signs that someone is having, or has had, a stroke? The sooner a person gets treatment, the better chance there is of recovery. "Clot-busting" drugs need to be administered within only a few hours of a stroke event to be effective. Time is of the essence with stroke.

Doctors are saying that non-medical individuals can recognize a possible stroke by asking the person they are concerned about to do three simple things:

1. Ask the person to smile;

2. Ask the person to raise both arms and hold them up;

3. Ask the person to say a simple sentence.

If the individual has trouble with any of these actions, call 911 immediately and describe the symptoms to the operator.

For more information on the research behind these recommendations see the American Heart website at
http://www.americanheart.org/presenter.jhtml?identifier=3008841

The life you save may be that of someone you love.

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Elder CareTip

The Creator didn't include handles or grab bars on people. When we're trying to assist someone with getting up from a chair, or we're trying to walk with someone whose balance isn't good, a reliable handle would do wonders for both our backs and the safety of the person we're helping. Lifting under the shoulders is bad for everyone. Belt loops break at the most inconvenient times. There's the very real risk that the person we want to help may bring us down, too, if there's a bad fall.

One possible answer is a gait belt. These are the soft woven belts you see physical therapists and nurses put around the waist of a patient they want to safely assist. The gait belt gives you something sturdy and safe to hold on to. If it's loose enough to put two fingers behind (no looser) the "patient" can wear it all day without discomfort.

This is one piece of equipment that's not expensive. You can get increased safety for both you and your loved one for around ten dollars - a real bargain these days. Gait belts are available at most any medical supply store, or on the web at
http://www.vitalitymedical.com/VitalityMedical.storefront/EN/Product/
POS6524?AID=10273944&PID=1247687

I receive no compensation for this recommendation - I just think it's a doozy of a good product for the price and what it can do.

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Formerly, when religion was strong and science weak, men
mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic.
-- Thomas Szasz

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Just a quick reminder for those of you who have been meaning to get yourself or a loved one enrolled in one of the Medicare Drug Card programs - you have until the end of this month to do so without possibly losing some amount of coverage. It's a complicated matter at best. Try using the interactive planner at http://www.benefitscheckup.org

By the time we meet again, Spring will have officially sprung. Here's a cyber package of chocolate bunny ears for everyone who's so inclined. If you don't want yours, pass them along to someone who could use a hug.

See you on April Fool's day. Until then, don't keep us a secret. If you know other people who should be reading this too, then do them and us a favor by telling them about Elder CareTips™. Just send them this link:
http://eldercareteam.com/resources/newsletter.htm

Until next time,

Molly

© 2005 Molly Shomer, All rights reserved. You are free to use material from Elder CareTips: Mastering The Eldercare Maze™ as long as you include complete attribution, including live web site link and email link. I would appreciate it if you would let me know where the material will appear.

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Molly Shomer
Head Coach
The Eldercare Team
http://www.eldercareteam.com
molly@eldercareteam.com
(972) 395-7823