Bridging the Gap: Why Patient Assistance Programs Matter to PLWHAs

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

The Covid-19 pandemic has exposed numerous cracks in the U.S. public health system, but it has also demonstrated why patient assistance programs are invaluable tools bridging the gap for people living with HIV/AIDS (PLWHAs) who might have otherwise fallen through the cracks. Generally speaking, patient assistance programs assist people who have health insurance, but whose plans include high deductibles and/or high copayments; patient assistance program help people who are in-between jobs or maybe recently expired COBRA [Consolidated Omnibus Budget Reconciliation Act] insurance; and patient assistance programs often serve as a lifeline for people who have no health insurance and don't qualify for public assistance programs, such as the AIDS Drug Assistance Program (ADAP) or Medicaid.

The ADAP Advocacy Association has witnessed an increase in the number of PLWHAs inquiring about what help exists for them during Covid-19's uncertainty. Therefore, it seems relevant and timely to once again share information about some of the amazing patient assistance programs that exist for patients.

Photo Source: therigy.com

• NeedyMeds https://www.needymeds.org 

NeedyMeds is a 501(c)(3) national non-profit that connects people to programs that will help them afford their medications and other healthcare costs. NeedyMeds is not a program, so you can't sign up. They are an information source. They list programs that may provide you with assistance. You apply directly to those programs. NeedyMeds doesn't process any applications, determine eligibility, or supply medications. NeedyMeds does offer a useful Drug Discount Card. The free NeedyMeds Drug Discount Card App is available for iPhone and Android. In addition to the drug discount card and pharmacy finder to help you locate the 65,000-plus pharmacies nationwide that accept the NeedyMeds Drug Discount Card, the updated version has a drug pricing tool so you will know the estimated price of the drug when you pick it up at the pharmacy. 

• Partnership for Prescription Assistance https://medicineassistancetool.org

Pharmaceutical Research and Manufacturers of America (PhRMA) created the Medicine Assistance Tool (MAT) to provide a dedicated search engine that allows users to search for financial assistance resources available to them, their loved ones or patients in their lives through the various biopharmaceutical industry programs available for patients who are eligible. MAT is a free-to-use search engine that focuses its searches on patient assistance resources available to eligible patients. 

• Patient Access Network (PAN) Foundation https://www.panfoundation.org

PAN Foundation is an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic and rare diseases with the out-of-pocket costs for their prescribed medications. Partnering with generous donors, healthcare providers and pharmacies, they provide the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life. PAN Foundation's HIV Treatment and Prevention Fund (currently closed) offers financial assistance for HIV treatment and prevention medications. The annual assistance amount is $3,400, but patients may apply for additional assistance at the end of their eligibility period (subject to the availability of funding).

• Patient Advocate Foundation (PAF) https://www.patientadvocate.org

PAF is a national non-profit organization, which provides case management services and financial aid to patients with chronic, life-threatening, and debilitating illness. In 2020, PAF provided direct relief to more than 192,000 patients from all 50 states and each US territory representing 629 distinct diagnoses through 44 unique patient service programs. Their mission is reflected in the practical problems addressed and the specific populations served, including its HIV, AIDS and Prevention Co-Pay Relief Program. The annual maximum award level is $7,500. It also now offers Medical Insurance Premium Assistance!

• RxAssist https://www.rxassist.org/patients

RxAssist is a nationally recognized, web-based medication assistance resource center. Established in 1999 with funding from The Robert Wood Johnson Foundation, RxAssist gives providers, advocates, consumer and caregivers comprehensive, up-to-date information in an easy to use format. It also offers a prescription discount card, Inside Rx, with saving on medications made simple. 

The ADAP Advocacy Association does not endorse one of these programs over another one, but rather encourages PLWHAs facing medical financial toxicity to consider all of the available options. Patient assistance programs reinforce the importance of the partnerships that exist between industry and non-industry partners, and any time is a good time to remind our community about them!

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Preventing Rx Medications from becoming the next toilet paper during the Coronavirus Pandemic

By: William E. Arnold, President & CEO, Community Access National Network (CANN)
       Shabbir J. Safdar, Executive Director of the Partnership for Safe Medicines
       Brandon M. Macsata, CEO, ADAP Advocacy Association

If you are taking a life-saving HIV medication right now, or any kind of life saving medication, you probably have two big concerns: “Can I afford my medicine if my economic status changes?” and “Will my medicine be in short supply? Will people do to medicines what they have done to toilet paper?”

Photo Source: USA Today

If you are concerned about affording medication, we strongly suggest exploring the tips in our COVID-19 one pager [English PDF, Spanish PDF] where we talk about the options offered by NeedyMeds, RXOutreach, and MedicationAssistanceTool.

If you are concerned about supply, don't turn to the wild west of foreign web pharmacies. That's more dangerous now than ever. Online scammers pretending to be Canadian, or in some cases actual Canadian criminals, have been perfecting their perfect-looking counterfeits and their fake-but-real looking web pharmacies for twenty years. You can find safe, U.S.-licensed online pharmacies at www.safe.pharmacy. No foreign pharmacy (even if it’s licensed in a trustworthy foreign country, like Canada) is safe for Americans to buy from.

But the good news is that you probably won’t have to. The American Medical Association has warned physicians against non-medically necessary prescribing to enable panic-buying. And pharmacy boards like those in Idaho, Texas, Nevada, West Virginia, and Ohio are tightening rules around prescriptions of medications, especially medicines like chloroquine, which may or may not be effective treatments for COVID-19. (For your reference, the National Alliance of State Pharmacy Associations is keeping a continuously updated list of state actions affecting Hydroxychloroquine, Chloroquine, and Azithromycin).

In the HIV space, ADAP Advocacy Association has published statements from nearly all the major manufacturers explaining that their supply is secure for the next twelve months, so panic-buying your medication is not advised, and if we all did it, would create a shortage where one does not exist today.

Photo Source:  master control.com

Ok, but what if I’m still concerned about making sure I’ve got enough medication for myself?

Talk to your pharmacist (and if you don’t do that often, go meet your pharmacist)
Call your pharmacist. If you can’t get them on the phone, you can go see them, but in this time of social distancing they would probably prefer a phone call. If you don’t have a relationship with your pharmacist this is a great time to begin one.

Let your pharmacist know about your medication needs for the next three to six months. If everyone orders a year’s supply of medication at once, the rush could create shortages. If your pharmacist knows about your needs, they can take them into account when they are ordering stock.

Plan to refill your prescription a ten-days ahead of time
If there is a shortage, your pharmacist has options to secure enough medicine for you, but they will need enough time to work it out. If you go in ten days ahead of time, that will give your pharmacist enough notice. If your insurance doesn’t allow you to refill ten days out, then call your pharmacist ten days out to let them know you’ll be coming in for a refill.

Ask your prescriber and pharmacist about a 90-day prescription
If you want to minimize trips to the pharmacy during this time, ask your prescriber about writing you a prescription for a 90-day supply instead of 30 days. Your pharmacist can tell you in advance if your insurance will cover a 90-day prescription before you even contact your physician.

Pharmacists and pharmacy techs may be the healthcare professionals you see the most often, and they know a great deal about medicine, the supply chain, and the best way to help you afford your medications. But they are working long stressful hours right now instead of sheltering at home---and they may need a little bit of planning to be your best ally.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.

Linkages to Care - Plugging the Treatment Gap: Navigating Patient Assistance Programs

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

In the United States, everyone hates how insurance companies "stick" it to consumers. There is pretty much universal agreement that the cost of prescription drugs are too high. There is also near consensus that the marketplace plans under the Affordable Care Act ("ACA") have caused a lot of headaches for patients with chronic conditions — including HIV/AIDS — especially with respect to the high tier drug plans. It is no wonder that so many cracks exist within the current healthcare framework. Fortunately, there also exist patient assistance programs ("PAPs") designed to plug the treatment gaps for these patients. PAPs serve as key linkages to care...and treatment!

According to PatientAssistance.com, "Commonly referred to as PAPs, Patient Assistance Programs are services offered by pharmaceutical companies for those who cannot afford their medication. Patient assistance programs are available to low-income individuals or families who are under-insured or uninsured and are provided to those who meet the eligibility guidelines. Assistance may range from reduced cost of drugs to free medicine. Each drug that a company offers will have its own unique program and may even have a different eligibility requirement than the other drugs they offer. As there is no unified standard of designation for these programs, you may also see them referred to as medication assistance programs, indigent drug programs, and charitable drug programs."[1]

Photo Source: MedicineCoupons.net

PAPs are vitally important to patients living with chronic conditions. They not only improve access to care and treatment, but they also save consumers money and reduce lost productivity. They also benefit the drug manufacturers because PAPs keep patients (would-be consumers) in treatment. The data shared by the Partnership for Prescription Assistance ("PPA") — which connects qualifying patients with the assistance program that’s right for them — is mind-blowing.

Celebrating its 12-year anniversary, PPA recently reported that its website is visited by over 75,000 consumers per month and makes available information on more than 475 patient assistance programs. It also offers a database of nearly 10,000 free or low-cost health care clinics across the country. Over 10 million consumers have been helped since the program's inception.[2]

Aside from the resources made available to consumers directly from the drug manufacturers, there also exists other patient-centric organizations designed to assist patients with prescriptions, discount drug cards, and other patient resources. Just to name a few, they include the Patient Access Network Foundation ("PAN"), Patient Advocate Foundation ("PAF"), and NeedyMeds. Each of these organizations serve as vital linkages to care for social workers, case managers, and allied health professionals assisting patients. These organizations also each partner with the ADAP Advocacy Association.

In an effort to raise awareness about patient assistance program and how they serve people living with HIV/AIDS and/or viral hepatitis, we will host an educational training webinar on May 31, 2017. The webinar, "Plugging the Treatment Gap: Navigating Patient Assistance Program," will showcase important information about these patient-centric PAPs. It will provide webinar attendees with a greater understanding about patient assistance programs, tools for how to navigate patient assistance programs to best assist patient needs, strategies for better seamless delivery of health-related care and treatment, and useful resources and tools to plug the treatment gap.

Registration is open to all stakeholders. Registration is complimentary for PASWHA members, and it is also complimentary for patients living with HIV/AIDS. Use this scholarship link if you are a patient living with HIV/AIDS applying for a webinar scholarship.

Additional information about the webinar is available online at https://www.123signup.com/event?id=nhjqn.


__________
[1] PatientAssistance.com (2014); The Catalyst; What are Patient Assistance Programs?; PatientAssistance.com, Inc. Retrieved from https://www.patientassistance.com/faq.html.
[2] Mooney, Hannah (2017, April 5); 12 years of the Partnership of Prescription Assistance; Pharmaceutical Research and Manufacturers of America®. Retrieved from http://catalyst.phrma.org/12-years-of-the-partnership-of-prescription-assistance.