Patient assistance programs and patient advocacy foundations: alternatives for obtaining prescription medications when insurance fails.

PURPOSE: The role of patient assistance programs and patient advocacy foundations as a safety net for Americans without health insurance or with inadequate insurance, the financial impact of 14 years of experience promoting enrollment in such programs at a cancer treatment center, and resources and strategies that pharmacists can use to increase patient enrollment and access to needed medications are discussed.
SUMMARY: Various patient assistance programs and patient advocacy foundations offer financial and other support for patients who need help obtaining prescription medications because they lack health insurance or their insurance fails to meet their needs. Patients must complete an application and provide personal financial information. Efforts by a pharmacist at a cancer treatment center to enroll patients in such programs produced a marked reduction in write-offs over a 14-year period. Pharmacists can promote patient enrollment in assistance programs by screening for costly drugs and patients who are likely to have difficulty obtaining these drugs. These patients include those who exceed Medicaid coverage or for whom Medicaid coverage is pending, patients without any health insurance, patients without a prescription drug benefit, patients for whom the planned drug therapy is not covered by insurance, and patients enrolled in charity programs.
CONCLUSION: Patient assistance programs and patient advocacy foundations provide a valuable safety net to ensure that Americans without health insurance or with inadequate coverage receive needed prescription medications.