Why Can Some Patients Get Free Drugs While Others Can't?

Many pharmaceutical companies offer free drugs, but critics complain such Patient Assistance Programs don't go far enough

By Diana Holden

Six years ago, Carla Miller was an active woman who enjoyed outdoor activities such as camping. Then things started to go wrong. "I just had tremendous pain that would kind of come and go," she says. "It started in my knees and then it moved to my hands and feet." She was diagnosed with rheumatoid arthritis, an autoimmune disease that attacks the joints. Two years ago Miller, now 53, discovered she also had a rare disease that affects her lungs. "If I moved too fast or lifted a heavy object I would become short of breath," says the former office worker. "I tried to work and would become very ill and had to go home."

When Miller's doctor suggested Humira, an injected medicine manufactured by Abbott Laboratories (ABT) for her arthritis pain, she didn't think she could afford the nearly $300 co-pay. Her doctor suggested applying for a co-pay assistance program through the pharmaceutical company that makes the drug. She applied and received a card in the mail with which to purchase her medication. "They called and said I was approved and that my co-pay was going to be zero," Miller says. "I couldn't take [Humira] without it."

Most large pharmaceutical companies offer financial support, and some help underinsured patients through co-pay programs. Many states offer assistance, too. "There's still a lot of people who don't know about [these programs]," says Dr. Richard Sagall, the president of NeedyMeds.org. His Web site compiles information about patient assistance programs (PAPs). "Some of the companies give away very expensive drugs easily." Sagall started the site a dozen years ago, when he was a family and occupational physician in Bangor, Me. He found out about the programs and decided to put his recently learned Web site designing skills to use. "I thought I was a pretty socially aware person, but I hadn't heard of them," he says.

Complicated Forms

Sagall warns that it may not be easy for some people to apply for the programs. "There are other companies that are very difficult to work with," he says. The application forms can be complicated, and patients might be rejected "if you forget to dot an i or cross a t." Still, "It is free medication for those who can't afford it," he says.

For Miller, who lives near Tampa, it was a godsend. She had been laid off from work because she couldn't work full-time and qualified for disability assistance more than a year later. Her husband, a plumber, was laid off last year and is still looking for work.

What's the best way to start the process? First, talk to physicians, who should be aware of these programs. Needymeds.org, pparx.org, and rxassist.org all assemble information about PAPs. States post information online about financial assistance for residents. It takes patience and persistence to navigate the system, but for those who are willing to make the calls and do the research, the benefits can be immense.

Easier to Qualify

The recession has had an effect on many people's ability to pay for their prescriptions. Some companies are responding with improved payment options. Merck (MRK), which makes such common drugs as Singulair for asthma and Januvia for diabetes, increased the amount of total annual income a family can make and still qualify for free medication in March. Individuals making less than $43,000 and families of four making less than $88,000 now make the cut. Over the last seven years, Merck says it has helped 1.7 million patients with $1.9 billion of medicine. Merck made $23.85 billion in worldwide sales last year.

Biogen Idec (BIIB) has a payment plan for two of its multiple sclerosis drugs, Avonex and Tysabri.

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