As the cost of prescription medicine continues to increase, many Americans do not have adequate insurance coverage for this expense. Actual spending on prescription drugs in the United States rose 17.1% from 2005 to 2006 while the average cost of prescription drugs rose 10.1%. Lower income Americans may be forced to choose between paying for essential medications or food.
A recent Harris Poll of 1100 adults found that 22% of those surveyed had not filled at least 1 prescription for medications during the year to save money. The problem is even greater in households with lower incomes. In households with incomes less than $25,000, 40% did not fill at least 1 prescription, and 30% took prescription medications less often than prescribed to save money. Along with multiple medications for hypertension, diabetes, or other systemic illnesses, ophthalmology patients often require long-term medications for the treatment of glaucoma, uveitis, or dry eye. Ophthalmology patients may view expensive sight-saving medicine as nonessential, especially when prioritizing the many systemic medications they require each month.
There are many ways ophthalmologists can help their uninsured or low-income patient obtain their much needed medicine at no cost, directly from the pharmaceutical manufacturers. Virtually all drug manufacturers offer assistance programs for those who have no prescription drug coverage and whose income falls below certain levels. These programs are not widely publicized, and many ophthalmologists and other healthcare professionals may be unaware of the programs. There are several ways to obtain information regarding these programs. The American Academy of Ophthalmology (San Francisco, CA) publishes the Directory of Ophthalmic Pharmaceutical Assistance Programs for the Medically Underserved. This directory was created by the Foundation of the American Academy of Ophthalmology’s EyeCare America program. This guide is free to ophthalmologists and provides an alphabetical list of ophthalmic medications and the manufacturer of each medication. The manufacturers are subsequently listed with information regarding the assistance programs of each manufacturer.
Pharmaceutical Research and Manufacturers of America (PhRMA) (Washington, DC) provides a list of manufacturers’ advertised patient assistance programs free of charge.
A review of several manufacturers’ patient assistance programs reveals that these programs are currently being used by many who are aware of the programs. Patients must apply separately to each company for each medication and reapplication is typically required every 3 months. Patients may need to provide proof of income such as a tax return or notarized affidavit of financial need. Drugs are either shipped directly to the patient or to the physician’s office. Several of the applications require the physician to fill out applications on behalf of the patient. This paperwork may be burdensome but ultimately, as the patient’s advocate, the physician may be able to ensure that patients will receive sight-saving medications and avoid a potential decision between paying for food or paying for prescriptions.
There are several prescription assistance companies that act as an advocate for the patient and provide a valuable service. These companies will complete all the paperwork, coordinate the physician’s portion and appeal any denials, which is common. For patients that have multiple medications and other physicians in addition to their ophthalmologists these firms provide a very valuable service.
Additional resources that might be able to help are:
BenefitsCheckUp helps thousands every day to find programs for people ages 55 and older that may pay for some of their costs of prescription drugs, health care, utilities, and other essential items or services.
A public service of the U.S. Administration on Aging, the Eldercare Locator connects older Americans and their caregivers with sources of information on senior services. The service links those who need assistance with state and local area agencies on aging and community-based organizations that serve older adults.
Medicaid – www.cms.hhs.gov
The official U.S. government Medicaid site for consumers, with links to state-administered programs.
The official U.S. government site for people with Medicare.
www.Rxhelp4u.com A Prescription Assistance Company
RxAssist provides qualified low-income individuals and families with access to generic versions of brand name medications.
Social Security Online – www.ssa.gov
The official Web site of the U.S. Social Security Administration.