Accessing Targeted Treatments

September 16, 2014
Hemophilia Reports, January 2014, Volume 1, Issue 1

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.