Getting Financial Help With Drug Costs

by GregP_WN

How to pay for cancer treatment? You've been diagnosed with cancer, the plan of treatment has been determined, it includes a new drug that has shown great promise for stopping your type of cancer. All you need is $57,000.00 per treatment, and you will need twelve. No problem, right? Here are some tips and resources for getting financial help with drug costs.

Getting Help With The High Costs Of Chemo Drugs

If you have been dealing with cancer treatment costs for any time at all you have undoubtedly realized that this is probably going to cost a lot of money. So you're going to need help with these expenses.  Do you have insurance? How much will it pay? Will it cover the drugs that you will be prescribed? Will you be treated on an outpatient basis, or in the hospital? Are you on a trial program? Some trial drugs are not covered by most insurance policies unless approved in advance. How do you find out? Will you be able to get treatment if your insurance doesn't pay? There are a lot of questions. In this article, we will try to give you some tips on how to find some help, and the steps that will be needed to get it. 

If you have seen the ads on TV for certain drugs, you may have noticed at the bottom of the screen in very small letters a line that says something to the effect of "For help with prescription drug costs call 555-555-5555" or when you're online and a drug add pops up, sometimes you will see the same message. So what doesn't this mean? Can anyone get free drugs? Not really, you have to meet certain qualifications. Below is a description of my experience when I tried to find financial help for Opdivo, a Bristol Myers Squib product. They also produce Yervoy, Orencia, 

When I went to Bristol Myer's site, I saw a link for financial aid and it took me to their Bristol Myers Squibb Patient Assistance Foundation that could help with expenses for their drugs. It's important to understand that this program is only for their drugs and this example only pertains to the Bristol Myers Squibb Patient Assistance Foundation (BMSPAF). If the drug you need help with is not one of their drugs, you can find a similar program with almost all drug companies. 

Starting with their link from their website for the Patient Assistance Foundation you will see this screen:


You will see that this program is only for the drugs listed below:

DAKLINZA™ (daclatasvir) ELIQUIS® (apixaban) EMPLICITI™ (elotuzumab) NULOJIX® (belatacept) OPDIVO® (nivolumab) ORENCIA® (abatacept) SPRYCEL® (dasatinib) YERVOY® (ipilimumab)
Then you will see the eligibility requirements listed below:

Eligibility Requirements
If you have been prescribed one of these medicines, you may be eligible for the BMSPAF if you:
*Do not have insurance coverage for your medicine listed on this site.
*Live in the United States, Puerto Rico or US Virgin Islands.
*Are treated by a US licensed prescriber.
*Are being treated as an outpatient.
*Have a yearly income that is at or below 300% Federal Poverty Level (FPL), $35,640 for a single person or $48,060 for a family size of two. Larger family sizes are adjusted accordingly. Medications that are injected and certain cancer medications may be subject to higher limits.
These are just some of the eligibility requirements. Other eligibility criteria may apply. For more information about eligibility, call the BMSPAF at 1-800-736-0003.

You can call the 800# listed to get more information, or look at the bottom of the screen and you will see the purple "Find out if you might qualify" button:


Clicking on the "find out" button takes you to a screen that asks you qualifying questions

Are you a resident of the US?

Are you being treated on an outpatient basis?

Are you being treated by a licensed physician?

What is your household income?

How many people live in your household?

After answering these questions you will see this screen if you have qualified:


When you click on the Download Application link you will get a PDF version of their application. It is a rather lengthy application, but just remember, a little time invested now can save you hundreds of thousands of dollars throughout your treatments. It's worth the time to do the legwork. All companies that offer assistance have to be sure that we as patients actually need help, that we are actually a patient, and that we are not just someone trying to scam some money from them. It's hard to believe, but yes, it happens, even in the cancer world. 

This particular application has a section for you to fill out in the "patient section" and another section for your doctor to fill out. Once it is complete, you mail or fax it to the BMSPAS and then wait for an answer. 

Other Resources

The process for finding help for the particular drug you need help with is the same. Simply Google the Company name and add, "patient drug assistance ". You will get several options to choose from in that search. I have found the patient assistance websites for the Companies listed below to help you:

Celgene - Patient Assistance  Makers of Revlimid and Pomalyst

Genentech - Makers of Rituxin

The Partnership for Prescription Assistance is an organization that has a list of companies that offer assistance. They are partnered with Cure Magazine.

The American Cancer Society has a resource page listing several drug companies that offer assistance.

NeedyMeds is a non-profit company whose mission is to help those in need to obtain affordable healthcare. The video below explains a little about how they work. 

Merk Patient Assistance Program - Merk Helps Makers of Keytruda

Recent Conversations About Drug Expense Help on WhatNext

"Merck Access Program pays for 2 treatments which are $12,500.00 an infusion, which is about $150,000.00 a year. Every 3 weeks I get an infusion, I'm still waiting for the cancer center to see what else I can qualify for, trying to stay alive is very expense, this does not include the radiation treatment or cancer doctor visit or pain management doctor prices or scan ie ,,ct pet scans or lab work before every infusion before I'm allowed to do treatment ..." Biga17133

"I take a Gleevec chemo pill, and my co-pay is $155 for 90 days. Novartis has a $10 co-pay card that allows me to pay only $30 for 90 days. My insurance pays close to $18,000 for 90 days."- "BarbarainBham

"My insurance didn't cover Emend, but I was able to get it at no charge through Merck's ACT Program:

When my port gave me a blood clot, I was able to get Xarelto at no charge through Janssen's Care Path program:

In the case of Emend, my chemo nurse told me about the program. I forget whether she gave me the paperwork or whether I got it online, but I had to supply a copy of my tax info to see if I qualified. When I did I was given a special number to call to order each pill packet, which was delivered via FedEx a couple of days before my infusion.

In the case of Xarelto, the patient advocate at my hospital registered me for the program while I was still an inpatient. I received a card and a support packet and had to show the card at my pharmacy.

My partner takes Premarin and was given a discount card by her nurse practitioner. I showed the card at the pharmacy, which now has the discount on file:
The discount cuts the cost roughly in half."
- "Ejourneys"

"I received copay assistance from PAN Foundation. You have to have insurance, and they have to have funds available for your particular kind of cancer (their source of funding is from donations that are usually earmarked for a specific cancer). Their application process is fairly easy. Here is a link to the drugs that they cover." - " JaneA "

"My Dad wrote letters to all of the drug companies that made the drugs that he was using. He did get grants from a few drug companies. One company even paid for his co-pays! -"HeidiJo"

Related Resources Page at WhatNext

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