Hepatitis PAP and Co-Pay Programs : Patient Assistance and Co-Pay Programs for Viral Hepatitis Drugs
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Patient Assistance and Co-Pay Programs 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. This page will be updated as new treatments are released and in the event that these programs evolve over time.

Different pharmaceutical company programs have different eligibility criteria based on the federal poverty level (FPL). The 2013 FPL income for an individual is $11,490. 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 that files joint taxes will be judged on their combined income. People who file individual income 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 and hope 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.

Hepatitis B Virus (HBV)

Bristol-Myers Squibb
Drugs covered: Baraclude
Contact Information: 855-898-0267. 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 the first $200 per month of co-pays.  For people who pay for their prescriptions in full, the program will also cover the first $200 per month.  Currently the program runs through December 31, 2014.

Gilead Sciences
Drugs covered: Viread
Contact Information: 877-627-0415
Program Details: The program starts after the first $50 and covers up to $200 per month co-payment for Viread for HBV treatment for patients who are uninsured or pay their prescription costs in full.  The program renews automatically for enrolled patients.

ViiV Healthcare
Drugs covered: Epivir
Contact Information: 877-844-8872 or www.mysupportcard.com
Program Details: The program covers up to $200 dollars per prescription per month and includes non-HBV drugs.

Hepatitis C Virus (HCV)

Gilead Sciences
Drugs covered: Sovaldi (sofosbuvir)
Contact Information: 855-769-7284 or www.MySupportPath.com
Program Details:Support The Sovaldi Copay Coupon Program can bring copays down 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.

Johnson & Johnson/Janssen
Drugs covered: Olysio (simeprevir)
Contact Information: 855-5-OLYSIO or www.olysio.com
Program Details:The Janssen Therapeutics Patient Savings program assists those who qualify by reducing their copays or coinsurance for Olysio to no more than $25 a month. This translates to a total of $75 for the three-month regimen of the drug in most cases. The maximum financial assistance is $25,000 for the 12-month period after you qualify, or until you've filled three bottles of Olysio, whichever comes first. To qualify, your household income must be under 500 percent of the federal poverty level, although you can appeal for total coverage if your income is higher. This offer is not available for those enrolled in Medicare or Medicaid.

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 and at merck-cares.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 and at merck-cares.com, which offers eligible patients up to $200 savings on their copayment for each Pegintron prescription, on up to 12 prescriptions.

Vertex Pharmaceuticals
Drugs covered: Incivek
Contact Information: 855-837-8394 or www.incivek.com
Program Details: Vertex will cover co-pay costs up to $10,000 for people who have private insurance plans that cover Incivek, regardless of their household income.  

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.bmspaf.org
Program Details: The PAP is for people who do not qualify for other assistance or health insurance programs and covers people with Incomes up to 300 percent of the FPL. 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.

ViiV Healthcare
Drugs covered: Epivir
Contact Information: 877-784-4842 or www.viivhealthcareforyou.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 FPL percentages. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down.

Hepatitis C Virus (HCV)

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: Sovaldi (sofosbuvir)
Contact Information: 855-769-7284 or www.MySupportPath.com.
Program Details: Called Support Path, Gilead's program may provide 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 new health exchanges available through Obamacare.

Johnson & Johnson
Drugs covered: Procrit*, Olysio (simeprevir)
Contact Information: 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 for anemia—a side effect commonly caused by the drug ribavirin, which is a component of many hepatitis C regimens.

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% FPL income eligibility requirement.

Vertex Pharmaceuticals
Drugs covered: Incivek
Contact Information: 855-837-8394 or www.incivek.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. The Incivek PAP helps people whose household income is less than $100,000 per year. Generally, programs will accept appeals for special circumstances if a person does not initially qualify and is turned down.

The above 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 10, 2014

This content is written by the Hep editorial team.

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