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Those struggling to pay for prescriptions have options

New Hampshire Sunday News

May 12. 2012 11:17PM

There is help out there for many New Hampshire patients struggling to pay for prescription medications. But you may have to jump through some hoops to find the right one for your situation.

-- Many drug companies have programs to assist patients with insurance co-pays and out-of-pocket drug costs.

-- Low-income seniors and others with Medicare Part D prescription plans may be eligible for 'extra help' to pay their drug costs.

-- Non-profit organizations such as the Chronic Disease Foundation can help patients who have certain illnesses.

-- In New Hampshire, the Foundation for Healthy Communities' Medication Bridge Program helps consumers work with pharmaceutical companies to obtain low- or no-cost drugs.

-- Patients enrolled in clinical trials can obtain their medications free of charge.

-- Some states have passed laws requiring insurance companies to cover oral chemotherapy drugs in the same fashion as infusion medications. That could go a long way to help patients pay for certain prescription medications.

Still, all of these programs have eligibility guidelines. Patients may have to have a certain income level, insurance coverage and even diagnosis in order to qualify.

Celgene Corp. manufactures the drug Revlimid, which can cost at least $7,000 for 30 pills. The company offers a 'patient support solutions' program that can provide up to six months of a medication free.

However, eligibility is limited, explained Brian Gill, Celgene's vice president of corporate communications.

The Food and Drug Administration has only approved Revlimid for two specific indications: myelodysplastic syndromes and some patients with multiple myeloma. Those are the only two diagnoses for which a patient can qualify for assistance, he said.

So a patient like Veronica Farrington of Sugar Hill, who has non-Hodgkin's lymphoma, would not qualify for the program until the FDA authorizes the drug's use for such patients.

However, Gill noted there are 'literally hundreds of clinical trials going on all over the world, across a broad swath of blood cancers as well as solid-tumor cancers.' Patients enrolled in such trials receive the medication, including Revlimid, for free, he said.

There are also nonprofit organizations that help patients pay for prescription drugs, but again you have to have the 'right' disease and medication to qualify.

The Chronic Disease Fund helps patients pay for prescription drugs, and Revlimid is on its list. However, non-Hodgkin's lymphoma is not, so Farrington wouldn't qualify for help.

Another nonprofit, the Patient Access Network Foundation, provides co-pay assistance for prescription medications, including up to $7,500 per year for a patient with non-Hodgkin's lymphoma, according to Korab Zuka, vice president of fundraising for PAN Foundation.

The nonprofit focuses on the under-insured and helps about 20,000 patients a year, according to foundation President Patrick McKercher 'There are people who for years have carried insurance and run into something like this and just have a burden that's just too big to bear,' he said. 'That's why we're there.'

But again, there's a caveat: A patient must have prescription drug coverage in order to qualify, and Farrington does not.

New Hampshire patients can take advantage of a program called Medication Bridge, which works with pharmaceutical companies to get patients reduced-price medications. There are income guidelines, however.

According to the American Cancer Society, 17 states and the District of Columbia have now passed 'parity' laws that require insurance companies to cover oral chemotherapy drugs the same way they do infusion medications.

Rep. Andrew Renzullo, R-Hudson, who sponsored a 2010 bill to let New Hampshire residents buy prescription drugs from Canada, had not heard of chemotherapy parity laws until now. But he said he will 'look into that' to see whether it would work in New Hampshire.

Celgene's Gill said passing such parity laws 'just makes sense.'

'It's equality of access for patients, so that they can have access to the most progressive, most innovative clinical therapies that are available in the marketplace,' he said. 'Whether they are oral-based, whether they are IV-based, stem-cell-based, patients should have access to therapies that are going to increase their prospects to live longer and live better lives.

'I think we would all want that.'

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