Pharmacy Financial Assistance

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Amgen, Inc.
Safety Net Program
800 272-9376
http://www.atdn.org/access/pa/filg.html  
Neupogen.  Based on guidelines determined by program. See website for guidelines.

Benefits Checkup
www.benefitscheckup.org
Finds programs for people ages 55 and over that may pay for some of their costs of prescription drugs, health care, utilities and other services. 

Bone Marrow Foundation
800 365-1336
http://www.bonemarrow.org/
The Patient Aid Program was created to fill the financial gap transplant patients may experience over the course of treatment.  It covers the cost for donor searches, compatibility testing, bone marrow procurement, medication, transportation, housing expenses and many other ancillary costs associated with transplant.

Eli Lilly & Company
Lilly Cares Foundation Patient Assistance Program
800 488-2133
http://www.lilly.com/about/social/foundation/products/assistance_program.html
The patient cannot have prescription insurance and must be a US citizen.  Additional guidelines on the website. 

Gate Pharmaceuticals
Purinethol Access Program
877 254-1039
http://www.gatepharma.com/
The patient cannot have prescription insurance and must be a US citizen.  Additional guidelines are available on line. 

GlaxoSmithKline
866 728-4363
http://www.gsk.com/
For acyclovir.  The patient must have no prescription coverage for the medication and have an income at or below 200% of the Federal Poverty Level.  GlaxoSmithKline requests an advocate (health care worker) involved in the patient’s care to be the contact person throughout the entire process.  If approved, the patient may pick up the medication at a local retail pharmacy. 

HealthWell Foundation
http://www.healthwellfoundation.org/index.aspx
Helps individuals afford prescription medications they are taking for specific illnesses including but not limited to breast cancer, chemotherapy induced anemia, chemotherapy induced neutropenia, head and neck cancer and cutaneous T-cell lymphoma.  The foundation provides financial assistance to eligible patients to cover certain out of pocket health care costs including prescription drug coinsurance, co-payments, deductibles, health insurance premiums and other selected out of pocket health care costs.  Financial criteria is based on multiples of the federal poverty level, with family size taken into account.  Families with incomes up to four times the poverty level may quality.  The foundation considers the cost of living in the particular city or state.  Treatment must be in the United States.  Assistance is on a first-come, first-served basis when funding is available.

Leukemia and Lymphoma Society
www.lls.org
The Society’s Patient Financial Aid (PFA) program offers financial reimbursement for some medications, transportation and procedures for those in need.  Specific diseases include multiple myeloma, leukemia and lymphoma.  Reimbursement requests, up to a maximum of $500 per year, are processed through your local chapter and payments are issued directly to you.  Patient financial aid is limited to residents of the United States or its territories and US military personnel stationed abroad.
800 955-4572

Lymphoma Research Foundation
www.lymphoma.org
Devoted exclusively to funding lymphoma research and providing patients and healthcare professionals with information.  The LRF patient Aid Program provides grants of up 59 $500, to be used within six months, for quality of life expenses during treatment.  Patients can be reimbursed for child care, travel-related costs incurred while obtaining treatment, medical aids and devices, education and support meetings, and cosmetic aids and hygiene products not covered by insurance.  Must be US citizens currently receiving treatment for lymphoma and in financial need. 
800 500-9976

Managed RX Plans Inc
800 799-8765
A private pharmacy that accepts most insurance including prescription drug programs as full payment towards prescriptions.  Patient must have insurance with a 70% or better co-pay.  Shipping is free.

Merck Patient Assistance Program
1-800 727-5400
www.merck.com
Provides medicine free of charge for up to one year to eligible individuals who do not have prescription drug coverage and who, without our assistance, could not afford needed Merck medicines. 

National Patient Access Network Foundation
www.patientaccessnetwork.org
Assists patients diagnosed with Rheumatoid arthritis, cutaneous T-cell Lymphoma, anemia or patients receiving therapies for oncology cytoprotection with out-of pocket expenses. 

Needymeds
www.needymeds.com
Provides information on the programs many drug companies have that give away fee prescription medications to people who have no insurance and qualify for their programs.  Allows you to access the information on the drug by searching by drug or by manufacturer.  Based on income level. 

Patient Advocate Foundation
PAF Co-Pay Relief
700 Thimble Shoals Blvd., Ste 201
Newport News, VA 23606
866 512-3861
pap@patientadvocate.org
Provides direct co-payment assistance for pharmaceutical products to insured Americans who financially and medically qualify.  Effective January 1, 2006, they began to welcome new Medicare Part D beneficiaries who require assistance with their pharmaceutical co-payments.  Specific diseases include but are not limited to autoimmune disorders, and lymphoma.  The program offers personal service to all patients through the use of call counselors.  These counselors assist patients throughout the entire application process, screening for eligibility by collecting financial and medical information. 

Partnership for Prescription Assistance
888 477-2669
www.pparx.org
Provides information about how qualified patients can get free or nearly free medications.  For patients without prescription coverage, based on income level.

Patient Services Incorporated
800 366-7741
www.uneedpsi.org
PSI is a non-profit charitable organization, primarily dedicated to subsidizing the high cost of health insurance premiums and pharmacy co-payments for persons with specific chronic illnesses and rare disorders. 

Pharmaceutical Manufacturers’ Association
800 762-4636
www.phrma.org/patient
Guidelines and a listing of participating pharmaceutical companies with patient assistance programs.  The medication request must come from your physician.

RX Outreach
800 769-3880
www.rxoutreach.com
Patient assistance program that provides medicines to help treat ongoing health problems.  Charge a small administrative fee associated with obtaining each 90 day supply which also includes shipping and handling.  Eligibility based on household income and number of people living in your home. 

Together RX
www.together-rx.com
A free prescription savings program for qualified Medicare enrollees.

Together RX Access
800 444-4106
A free savings program that helps eligible participants save approximately 25%-40% and sometimes more on over 275 brand-name prescription drugs and other prescription products, as well as savings on a wide range of generic drugs. 

Upsher-Smith
866 851-2826
http://www.rxassist.org/pap-info/company_detail.cfm?CmpId=133
The patient must have no prescription coverage for the medication (folic acid) and meet income guidelines.  The patient must also be a US citizen. 

Xubex Pharmaceuticals
866 699-8239
www.xubex.com
Provides generic medications only.  Eligibility based on income.  Small fee with each 90 day prescription. 

 


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