Are you uninsured? If you do have health coverage, are your prescription co-pays or other co-insurance costs prohibitively expensive? Or does your plan come with high medication deductibles that you can’t afford? Help may be available from pharmaceutical companies and other organizations in the form of co-pay programs and patient assistance programs (PAPs).
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 no chance for you; you can always appeal to have the decision reversed or see if you are eligible for alternative financial assistance.
Co-pay and PAP Programs
Co-pay programs offer assistance to people with private insurance, reducing the co-payments or coinsurance costs required to obtain 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.
Patient assistance programs (PAPs) offer free hepatitis C drugs to lower-income people who are uninsured or underinsured, and who do not qualify for insurance programs such as Medicaid or Medicare.
If you are ineligible for co-pay or patient assistance funds because you have Medicare, Medicaid or another government-based prescription plan, and cannot afford your prescription(s), ask the pharmaceutical company to refer you to a patient advocacy organization (some are listed below).
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.
To find patient assistance and co-pay programs if you are coinfected with HCV and HIV, additional help is available at: HIV Drug Assistance Programs.
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.
Last Reviewed: March 7, 2019