E-DRUG: AstraZeneca launched new 'Patient Assistance Program' (7)
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I agree that AZ would not be doing this unless there was something in
it for them business wise. Many of the US pharmas have these
programs, often the motivating rationale is also to bolster their
public image in an attempt to use any and all means to stave off
government price controls on drugs. Following our elections of last
week, they are running more scared. Also, the new open season for
Medicare Part D enrollment begins on Nov. 15. And the companies often
create new programs to try to give themselves an edge over their
competitors.
To genuinely assess these programs, one also needs to look at the fine
print on eligibility rules, which the pharmas often will not disclose
to the public nor to healthworkers, only to individual applicants at
the time of application. The goal of the secrecy is keep us from
helping pts. to qualify. In this case, AZ seems to be disclosing the
income lid, but it remains to be seen how this will pan out.
While the PAPs offer the illusion of "caring", they also put up many
barriers for qualification. They sound good in print, but the reality
is often quite different on the patient's side. For example., saying
that the program is for the "uninsured": does this mean people with no
health insurance whatsoever, or only those who have no cover for
medicines? In addition to the complete uninsured, there are many
many people in the US who are under-insured: they have some insurance
but it is woefully inadequate to cover the costs of care and drugs for
diseases like cancer, for example. Often the under-insured are
excluded from PAPs because they have "insurance" in the literal sense
of the word.
Will there be dollar limits or specific Rx-product limits on the PAP
offering? many of AZ's cancer drugs, for example, are
astronomically expensive. Will there be a means test that includes,
or excludes, personal assets, takes into account family size,
extraordinary expenses, etc? Will there be a requirement that
applicants first apply and then be rejected by our public insurance
programs? Another issue to look at is that since the advent of
Medicare Part D, many of the pharma PAPs have been refusing to take
applications from people who are eligible for Medicare Part D ( i.e.
Medicare beneficiaries), even though participation in Part D is
voluntary. The pharmas have taken a lot of flak for this, and some
have relented. And regarding Medicare part D, will this AZ plan offer
benefits to people who are in the so-called "doughnut -hole" of Part
D where they have no prescription insurance ( having exhausted their
initial benefit, and then must accrue $5600 out-of-pocket expenses
before Part D's catastrophic benefit kicks in? Or will these people
be disqualified form AZ's [program because they have insurance, even
though it is not covering drugs they presently need? many times
those in the doughnut hole are advised to sue generics to cut costs,
but for many cancer treatment drugs, there are no generics.
PAPs also come with large administrative costs to accommodate the
bureaucratic requirements. Usually the pharmas contract out the admin
to pharmacy benefits management ( PBM) companies, adding yet another
layer of complexity and cost. Ann of course, the manufacturers also
contract with top-level PR firms to orchestrate their image building
campaigns for both PAPs and specific medicines.
There is always more than meets the eye in these programs. Anyone who
wants more info on these topics, feel free to contact me. With a great
deal of effort and even luck, PAPs can help some people temporarily,
but they are very far from being the solution to ensuring access to
affordable and appropriate medicines
--
Joana Ramos, MSW
Cancer Resources & Advocacy
7303 23rd Ave. NE
Seattle, WA 98115
206-229-2420
joaninha@comcast.net
References
1. http://ramoslink.info/
2. http://www.healthyskepticism.org/