September 19, 2023

What Are Patient Assistance Programs (PAP)?

Patient Assistance Programs, or PAP, have emerged in an effort to help patients who lack health insurance or prescription drug coverage obtains the medications they need. 

Allied pharmacy offers a Patient Assistance Program (PAP) to low-income individuals or families who are uninsured or underinsured and meet eligibility requirements.

Key Takeaways

  • The Patient Assistance Program (PAP) helps people who don’t have health insurance or who have no insurance to buy medicines.
  • These programs are administered by pharmaceutical companies, non-profit organizations, and government agencies.
  • PAP can cover the full cost of the drug or offer a discount.

An older man on the phone while checking something on his laptop in front of him. Many partially protected from the high cost of prescription drugs by their employer’s health insurance, Medicaid, or Medicare. However, coverage gaps and formula limitations can also weigh heavily on the insured. Also, those who do not have health insurance or adequate insurance must pay for their medication at their own expense. Patient Assistance Programs (PAPs) are usually sponsored by pharmaceutical companies and touted as a safety net for Americans without or underinsured health insurance. The goal of these programs is to provide financial assistance to these patients so that they can obtain medicines at little or no cost.

Where do patient assistance programs come from?

PAP is mostly sponsored by pharmaceutical companies. There are also government programs and non-profit sponsorship programs.

How does the Patient Assistance Program work?

If you don’t have insurance or don’t have enough insurance and can’t afford medication, these programs often offer free or low-cost options. The benefits you receive will vary greatly depending on the program. Also, programs often have different requirements.

How will I know if we are eligible?

Unfortunately, there is no standardized registration procedure. Each program defines and sets its own eligibility criteria.

In general, the following requirements should be met:

  • Must be a legal permanent resident of the United States or Puerto Rico
  • Prove that you have no insurance or that your insurance does not cover your medication
  • meet certain income requirements

To register, call the program or register online. To prove your eligibility, you must submit forms such as tax records and proof of residency. Most programs also require your healthcare provider to complete a form. Once enrolled, there may be restrictions on the number of medications you can receive and the duration of the program. For example, the manufacturer GlaxoSmithKline offers support programs for its drugs Benlysta and Nucala. Their eligibility section lists what your maximum monthly gross income must be below, depending on your household size and where you live.

What are some examples of these programs?

Below is a list of some of the largest patient assistance programs.

  • Gilead Advancing Access Program
  • GSK Patient Assistance Program
  • Health well Foundation
  • bread foundation
  • Lilly Cares Foundation Patient Assistance Program
  • Novartis Patient Support Foundation
  • Novo Patient Support Program
  • Pfizer Patient Assistance Program

Why is patient assistance programs criticized?

These programs can be very profitable, but they are difficult to access and understand. A 2009 survey showed that only half of the programs disclose their eligibility criteria. Many people think the signup process is deliberately confusing and time consuming.

A patient cannot usually apply for her PAP without the involvement of the care team because the provider must complete a portion of the application. A 2018 study suggests that providers do not always know which patients are best suited for which PAP due to the lack of clear information on suitability and benefit. These programs can also force patients to choose specific brand-name drugs, even when there are cheaper and more effective alternatives.

How do I find a patient assistance program for my medicine?

If you are taking certain medications and are unsure if PAP is available, you can:

  • Find your medicine on GoodRx and scroll down to see under “Savings Tips”.
  • Search Google for the name of the drug and ‘assistance program’ or ‘savings program’.
  • Call the drug manufacturer and ask if they offer a support program.
  • Check the directory for patient assistance programs.
  • Check out the GoodRx Helps Medication Assistance Program. It provides free medicine through community and non-profit clinics across the United States.

Final result

If you’re struggling with the cost of prescription drugs, PAP can help you buy medicines whether you have health insurance or not. Pharmaceutical companies, non-profit organizations, and government agencies all offer this kind of financial support. Some programs offer full coverage, while others offer discounts.

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