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Article
Hemophilia Reports
Accessing Targeted Treatments
The Fair Pricing Coalition (FPC) works closely with the pharmaceutical industry to ensure patient access to copay and patient assistant programs (PAPs) for people with HCV. Most pharmaceutical companies have collaborated with the FPC to coordinate programs that are typically based on income adjusted for family and/or household size.
The Fair Pricing Coalition (FPC) works closely with the pharmaceutical industry to ensure patient access to copay and patient assistant programs (PAPs) for people with HCV. Most pharmaceutical companies have collaborated with the FPC to coordinate programs that are typically based on income adjusted for family and/or household size. Copay programs offer assistance to people who have private insurance but who need help with coinsurance costs to obtain therapies for HCV at the pharmacy. The PAPs offer free HCV drugs to lowerincome patients who are uninsured or underinsured and who do not qualify for insurance programs such as Medicaid or Medicare.
Table 1. Copay and Patient Assistance Programs for Hepatitis C Therapies1
Product(s)
Covered Contact Information
Program Details
Co-Pay Programs
Gilead Sciences
Sovaldi (sofosbuvir)
855-769-7284 or
www.MySupportPath.com
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 apply toward prescription
deductibles and coinsurance obligations. The program is open to those with a maximum household
income of $100,000 for a family of up to 3 members, and 500% of the federal poverty level for
families with 4 or more members.
Johnson & Johnson/
Janssen
Olysio (simeprevir)
855-5-OLYSIO or www.olysio.com
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 3-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 3 bottles of Olysio, whichever comes
first. To qualify, your household income must be under 500% 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 866-939-4372 or
PegIntron and Victrelis
www.victrelis.com and
www.pegintron.com
Victrelis: Patients can print out a card at www.victrelis.com and at merck-cares.com, which offers
eligible patients savings of up to 20% of the total cost of each Victrelis prescription, up to 12
prescriptions (which would be a full 44 weeks of treatment for those who need it for that duration).
PegIntron: Patients 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
Incivek
855-837-8394 or www.incivek.com
Vertex will cover copay costs up to $10,000 for patients who have private insurance plans that
cover Incivek, regardless of their household income.
PAP's
Genentech/Roche
Pegasys and Copegus
888-941-3331 or
www.pegasysaccesssolutions.com
Most programs have limits based on the total household income compared with 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
Sovaldi (sofosbuvir)
855-769-7284 or
www.MySupportPath.com
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 3, and 500% of federal poverty
level for families with 4 or more members. You can also contact Support Path for assistance in
finding other sources of health coverage, such as through Medicaid, Medicare, or the new health
exchanges available through the Affordable Care Act.
Johnson & Johnson
Procrit9, Olysio
(simeprevir)
800-652-6227 or
www.jjpaf.org
The Johnson & Johnson Patient Assistance Foundation will provide free coverage of Olysio to those
who qualify. The income limit is 500% of the federal poverty level, although you can appeal if your
income is higher than that. For Procrit, the income cap is 400% of the federal poverty level.
Merck & Co
Pegintron and Victrelis
866-363-6379 or www.merckhelps.
com
The ACT Program can answer questions related to insurance coverage and reimbursement. Program
Specialists can also help you apply for the PAP. 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% federal poverty level income eligibility requirement.
Vertex Pharmaceuticals
Incivek
855-837-8394 or www.incivek.com
The PAP is for people who do not qualify for other assistance or health insurance programs and is
limited by income. 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.
PAP indicates patient assistance program. aProcrit is a treatment for anemia—a side effect commonly caused by the drug ribavirin, which is a component of many hepatitis C regimens.
Reference:
1. Hepatitis e-news. http://www.hepmag.com/articles/ hepatitis_paps_copays_20506.shtml. Accessed March 4, 2014.
