Hepatitis Assistance Programs : Patient Assistance and Co-Pay Programs and Other Resources for Viral Hepatitis Drugs
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Patient Assistance and Co-Pay Programs and Other Resources for Viral Hepatitis Drugs

  

Introduction

Are you uninsured? If you do have health coverage, are your prescription co-pays or other co-insurance costs prohibitively expensive? Or does your health plan come with high medication deductibles that you can't afford? Help may be available from pharmaceutical companies in the form of patient assistance programs (PAPs) and co-pay programs.

In recent years, the Fair Pricing Coalition (FPC) has been working closely with the pharmaceutical industry to streamline access to co-pay programs and PAPs for people living with viral hepatitis. The FPC has negotiated co-pay programs with virtually every major hepatitis drug manufacturer. Below is a list of co-pay and patient assistance programs for hepatitis B and C, including contact information for these programs. Different pharmaceutical company programs have different eligibility criteria based on the federal poverty level (FPL). Eligibility for this year is based on last year's income. The figure is adjusted based on family or household size. A complete table is available here. Unless otherwise stated, companies ask for verification of income, usually in the form of a federal income tax return. Companies also generally consider household income, meaning that a married couple filing joint taxes will be judged on their combined income. People who file individual tax returns will only have their individual income considered. If you are told you are ineligible for assistance, this does not mean there is still no chance for you; you can always appeal to have the decision reversed.

CO-PAY PROGRAMS

These programs offer assistance to people with private insurance for the co-payments or coinsurance costs required to obtain hepatitis B or hepatitis C drugs at the pharmacy. Many of these programs are not available for those enrolled in Medicare, Medicaid, or other government-based prescription plan.

Hepatitis B Virus (HBV)

Bristol-Myers Squibb
Drugs covered: Baraclude
Contact Information: 855-898-0267 or www.baraclude.com/all-in-one-access-program.aspx. Ask the operator to speak to someone about the Baraclude Co-pay Benefits Program and ask for a card to be mailed to you.
Program Details: The program covers up to $400 per co-pay. Provides up to $400 per prescription for eligible patients without prescription benefits.

Gilead Sciences
Drugs covered: Viread
Contact Information: 877-627-0415 or www.viread.com/en/my_access.aspx
Program Details: This program is for patients who are uninsured or who pay their prescription costs in full. Depending on eligibility, this program may pay up to the entire amount of the co-pay for HBV treatment using Viread.

Hepatitis C Virus (HCV)

AbbVie Inc.
Drugs covered: Viekira Pak (ombitasvir + paritaprevir + ritonavir) + (dasabuvir), Moderiba (ribavirin)
Contact Information: For Viekira, 844-277-6233 or www.viekira.com/proceed-program. For Moderiba, 844-663-3742 or www.moderiba.com/patient-support/financial.
Program Details: For Viekira, contact company to determine eligibility and amount of coverage. For Moderiba, $5 out-of-pocket co-pay card may be printed from website (for those who are eligible).

Genentech/Roche
Drugs covered: Pegasys and Copegus
Contact Information: 888-202-9939 or www.activatethecard.com/pegasys/welcome.html
Program Details: After you pay $25, the card pays 80 percent of co-pays up to $1,500 to $2,400 a year, depending on your income. Call or enroll in the co-pay card program online.

Gilead Sciences
Drugs covered: Harvoni (sofosbuvir + ledipasvir), Sovaldi (sofosbuvir)
Contact Information: 855-7MY-PATH (855-769-7284) or www.MySupportPath.com
Program Details: The Co-pay Coupon Program reduces co-pays to $5 in most cases for those who qualify. Financial aid for as much as $16,000 is also available to go toward prescription deductibles and coinsurance obligations. The program is open to those with a maximum household income of $100,000 for up to a family of three, and 500 percent of federal poverty level for families with four or more members.

Kadmon Pharmaceuticals
Drugs covered: Ribasphere (ribavirin)
Contact Information: 800-364-4767 or www.hcvadvocate.org/community/community_pdf/Riba_CoPay_Cards.pdf
Program Details: The Ribasphere Ribapak CoPay Savings Card assists those who qualify by reducing their co-pays or coinsurance for Ribasphere to no more than $5 a month. Complete the form on the website, print, and take with Ribasphere prescription and insurance card to your pharmacist.

Janssen/Johnson & Johnson
Drugs covered: Olysio (simeprevir)
Contact Information: 855-5-OLYSIO (855-565-9746) or www.olysio.com
Program Details: The Janssen Therapeutics Patient Savings program assists those who qualify by reducing their co-pays or coinsurance for Olysio to as little as $5 per fill. The maximum financial assistance is $50,000 for the 12-month period after you qualify. To qualify, your household income must be under 500 percent of federal poverty level, although you can appeal for total coverage if your income is higher.

Merck & Co.
Drugs covered: PegIntron and Victrelis
Contact Information: 866-939-4372 or www.victrelis.com and www.pegintron.com
Program Details: Victrelis: People can print out a card at www.victrelis.com which offers eligible patients savings of up to 20 percent of the total cost of each Victrelis prescription, on up to 12 prescriptions (which would be a full 44 weeks of treatment for those who need it for that duration). PegIntron: People can print out a card at www.pegintron.com which offers eligible patients up to $200 savings on their co-payment for each Pegintron prescription up to 12 prescriptions.

PAP PROGRAMS

These programs offer free hepatitis B or C drugs to lower-income people with who are uninsured or underinsured and who do not qualify for insurance programs such as Medicaid or Medicare.

Hepatitis B Virus (HBV)

Bristol-Myers Squibb
Drugs covered: Baraclude
Contact Information: 855-898-0267 or visit www.baraclude.com/all-in-one-access-program.aspx
Program Details: The PAP is for people who do not qualify for other assistance or health insurance programs and is limited by income. Most programs have limits based on the total household income compared to established FPL percentages. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down.

Gilead Sciences
Drugs covered: Hepsera, Viread
Contact Information: 800-226-2056 or visit www.gilead.com/us_advancing_access
Program Details: The PAP is for people who do not qualify for other assistance or health insurance programs and is limited by income. Most programs have limits based on the total household income compared to established FPL percentages. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down.

GlaxoSmithKline (GSK)
Drugs covered: Epivir
Contact Information: 866-728-4368 or www.bridgestoaccess.com; 866-518-4357 or www.gsk-access.com
Program Details: GSK's Bridges to Access program is for people who do not qualify for other assistance or health insurance programs and is limited by income. Most programs have limits based on the total household income compared to established FPL percentages. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down. The GSK Access program offers medication at no cost for qualified patients who are enrolled in a Medicare Part D prescription drug plan.

Hepatitis C Virus (HCV)

AbbVie Inc.
Drugs covered: Viekira Pak (ombitasvir + paritaprevir + ritonavir) + (dasabuvir), Moderiba (ribavirin)
Contact Information: 844-776-2333 or www.viekira.com
Program Details: Contact company to determine eligibility and amount of coverage.

Genentech/Roche
Drugs covered: Pegasys and Copegus
Contact Information: 888-941-3331 or www.pegasysaccesssolutions.com
Program Details: The PAP is for people who do not qualify for other assistance or health insurance programs and is limited by income. Most programs have limits based on the total household income compared to established federal poverty levels. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down.

Gilead Sciences
Drugs covered: Harvoni (sofosbuvir + ledipasvir), Sovaldi (sofosbuvir)
Contact Information: 855-769-7284 or www.MySupportPath.com
Program Details: Called Support Path, Gilead's program may provide Harvoni or Sovaldi coverage for free to those with a maximum household income of $100,000 for up to a family of three, and 500 percent of federal poverty level for families with four or more members. You can also contact Support Path for assistance finding other sources of health coverage, such as through Medicaid, Medicare or the Affordable Care Act.

Janssen/Johnson & Johnson
Drugs covered: Olysio (simeprevir), Procrit*
Contact Information: Olysio 855-5-OLYSIO (855-565-9747) or www.olysio.com/hcp/experience; Procrit 800-652-6227 or www.jjpaf.org
Program Details: The Johnson & Johnson Patient Assistance Foundation will provide free coverage of Olysio to those who qualify. The income limit is 500 percent of the federal poverty level, although you can appeal if your income is higher than that. For Procrit, the income cap is 400 percent FPL.
*Procrit is a treatment that may be prescribed off-label for anemia that may occur when ribavirin is used in the hepatitis C treatment regimen.

Merck & Co.
Drugs covered: Pegintron and Victrelis
Contact Information: 866-363-6379 or www.merckhelps.com
Program Details: The ACT Program can help you answer questions related to insurance coverage and reimbursement. Program specialists can also help you apply for the PAP. The PAP is for people who do not qualify for other assistance or health insurance programs and is limited by income. Most programs have limits based on the total household income compared to established federal poverty levels. Generally the program will accept appeals for special circumstances if a person does not initially qualify and is turned down, provided they fall within the 500 percent FPL income eligibility requirement.

OTHER PATIENT ADVOCACY PROGRAMS

In addition to pharmaceutical patient assistance and co-pay programs, patient advocacy programs may help you find affordable medication and navigate other issues relating to access to care.

Hepatitis B and C Viruses (HBV and HCV)

Partnership for Prescription Assistance (PPA)
Contact Information: 888-477-2669 or www.pparx.org
Program Details: The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need by matching them with the right assistance programs.

Patient Access Network Foundation (PAN)
Contact Information: 866-316-PANF (866-316-7263) or www.panfoundation.org
Program Details: The Patient Access Network Foundation offers help to people with chronic or life-threatening illnesses for whom cost limits access to medical treatments.

Hepatitis C Virus (HCV)

The Bonnie Morgan Foundation for HCV
Contact Information: 877-359-7235 or www.notwithoutafight.org
Program Details: The Bonnie Morgan Foundation provides information about hepatitis C treatment and co-pay assistance programs. They disburse charitable donations for those who need help paying prescription drug co-pays and deductibles.

Patient Advocate Foundation's Hepatitis C CareLine
Contact Information: 800-532-5274 or www.hepatitisc.pafcareline.org
Program Details: Patient Advocate Foundation's Hepatitis C CareLine is a patient/provider hotline designed to provide assistance to patients who have been diagnosed with hepatitis C and are seeking education and access to care.

HCV-HIV Coinfection

To find patient assistance and co-pay programs if you are coinfected with HCV and HIV, check out: Help Paying for Meds: Patient Assistance and Co-Pay Programs for HIV and Viral Hepatitis Drugs

The information on this page is based on a document originally produced by the Fair Pricing Coalition, an ad hoc group of activists who advocate with the pharmaceutical industry regarding the price and patient access to HIV and viral hepatitis drugs. For more information, please visit www.fairpricingcoalition.org.


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Last Revised: January 08, 2015

This content is written by the Hep editorial team.

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