Help Your Low Income, Uninsured Patients Get Rx Help

As the price of prescription drugs continues to increase, many Americans do not have adequate insurance coverage for this expense and they need prescription drug help. Actual spending on prescription medicine in the United States rose 17.4% from 2005 to 2006 while the average cost of prescription drugs rose 10.2%. Lower income, uninsured Americans may be forced to choose between paying for essential prescriptions or food. A recent Harris Poll of 1300 adults found that 23% of those surveyed had not filled at least 1 prescription for medicine during the year in order to save money. The problem is even greater in households with lower incomes. In households with incomes less than $25,000, 40% did not fill at least 1 prescription, and 30% took prescription medication less often than prescribed to save money. Along with multiple prescription drugs for hypertension, diabetes, or other systemic illnesses, ophthalmology patients often require long-term prescriptions for the treatment of glaucoma, uveitis, or dry eye. Ophthalmology patients may view expensive sight-saving medicine as nonessential, especially when prioritizing the many systemic prescription medicine they require each month.

There are many ways physicians can help their uninsured, low-income patient obtain their much needed medicine at no cost, directly from the drug companies. Virtually all pharmaceutical manufacturers offer assistance programs for those who have no prescription medicine coverage and whose income falls below certain levels. These programs are not widely publicized, and many ophthalmologists and other healthcare professionals may be unaware of the programs. There are several ways to obtain information regarding these programs. The American Academy of Ophthalmology (San Francisco, CA) publishes the Directory of Ophthalmic Pharmaceutical Assistance Programs for the Medically underserved. This directory was created by the Foundation of the American Academy of Ophthalmology’s Eye Care America program. This guide is free to ophthalmologists and provides an alphabetical list of ophthalmic prescription drugs and the manufacturer of each medication. The manufacturers are subsequently listed with information regarding the assistance programs of each drug manufacturer.

Pharmaceutical Research and Manufacturers of America (PhRMA) (Washington, DC) provides a list of companies providing patient assistance programs free of charge. A review of several drug manufacturer patient assistance programs reveals that these programs are currently being used by many who are aware of the programs. Patients must apply separately to each company for each medication and reapplication is typically required every 3 months. Patients may need to provide proof of income such as a tax return or notarized affidavit of financial need. Drugs are either shipped directly to the patient or to the healthcare provider’s office. Several of the applications require the physicians to fill out applications on behalf of the patient. This paperwork may be burdensome but ultimately, as the patient’s advocate, the healthcare provider may be able to ensure that patients will receive sight-saving medicine and avoid a potential decision between paying for food or paying for prescription medication.

There are several drugs assistance companies that act as an advocate for the patient and provide a valuable service. These companies will complete all the paperwork, coordinate the physician’s portion and appeal any denials, which is common. For patients that have multiple medicine and other healthcare provider in addition to their ophthalmologists these firms provide a very valuable service.