1. How to Get Free Stuff: A Guide to Patient Drug Assistance Sara Baker, Mike Chacey University of Kansas School of Medicine

2. The Need for Assistance At current estimates, there are 45 million people living in the United States without Health Insurance This is 15.6% of our population Many patients with insurance lack prescription benefits

3. The Cost of Medicine Monthly Costs for Typical Patient Metformin 1000 mg BID $55.99 Avandia 4 mg qd, $83.11 Losartan 50 mg qd, $47.99 Lipitor 20 mg qd, $96.99 Advair 250/50 BID $139.99 Zoloft 100mg qd $77.99 Totaling $502.06 per month, or $6024.72 per year

4. The Result For the 36 million at or below the poverty level ($9,393/year) this is an insurmountable cost. Even for people with higher earnings, the cost of paying for prescription medications is prohibitive. The end result is that the patient will not take their medications.

5. How Can You Help? Every major drug company offers medications through Patient Assistance Programs These programs provide medication, free of charge, through the mail to needy patients

6. Setting Up DAP in your Office It is simple to set up a DAP in your office. It increases the length of an office visit less than 10 minutes, or only seconds if you have staff that can help

7. Setting up a DAP in your Office 1.Have the forms ready. You can print them off in advance, or most forms can be reached at www.needymeds.com and printed off as needed. www.needymeds.com 2.Follow the directions on the form, be sure to fill out every blank, and send it in

9. Setting up a DAP in your Office 3. Fill out a tracking form, so that medications don’t get lost.

10. Setting up a DAP in your Office 4. Have each patient sign a waiver so that you are not liable if the patient is not accepted.

12. Choosing a Program Each drug company has its own requirements for their program. Some patients will be eligible for some programs, but turned down for others. Luckily, there are so many medications within a class, that you can steer your patient into a program that will meet their needs

13. Using Drug Assistance Programs (DAP) Patients initially qualify by meeting certain income criteria The criteria vary from company to company, but a general guideline is as follows:

15. RequirementsMerckPfizer/Parke Davis SSNIf none, write none and Send to alt address sketchy US CitizenRequired Income Verification noneMust have tax return, or fill Out 4506, complete sections 1-4, check 8b and sign RXNone (use form)Required RefillsRefill packet or call 1-800-473-3455 New Application every Three Months, proof of income good for 1 year Mail tohomeoffice Other CommentsUse refill packets to reorder, or call number, or customer service. If no SSN send to Attn: Jean Kelly Merck Patient assistance Po Box 1985 Horsham PA 19044-9848 Must have tax return or fill out 4506. If that cannot be Done, call 1-800-707-8990. Pay check Stubs won’t cut it ContactMerck Patient Assistance PO Box 690 Horsham PA 19044-9979 Connection to Care PO Box 66585 St Louis MO 63166-6585 1-800-707-8990 FaxnoNo Common Meds Available Cozaar, Hyzaar, Fosamax Proscar, Singulair, Zocor Accupril, Bextra, Caduet, Cardura, Celebrex, Detrol, Dilantin, Glucotrol Lipitor, Neurontin, Norvasc, Procardia Relpax, Zoloft, Zyrtec

16. GSK: The exception to the Rule The assistance program through GSK is unique. Patients fill out the form, and it is called into the company by a Registered Patient Advocate. The patient is given a coupon, which can be redeemed at any pharmacy for a 2 month supply of medication, for a $10 copay. The remaining 10 months are sent to the patient through the mail.

17. Our Favorite Programs After many years of patient assistance, it has become evident that some programs yield higher success than others. Our greatest success has been with GSK, Bristol Meyers Squib, and Merck. These programs’ credentialing and income verification are very user friendly, and patients are usually accepted.

18. Affordable Drugs: The simplest Solution. Of course the most logical thing to do is to choose medications that a patient can reasonably afford. Choosing the cheapest medication is not always as easy as you think, with counterintuitive dose and form pricing. Here is a guide to some of the most common affordable medications.

20. RX Outreach Sometimes, even the cheapest generic is to much for patients to afford. Luckily, at www.rxassist.org, you can enroll your patients for Rx Outreachwww.rxassist.org For $6 a month patients can get most generic medications through mail if they are accepted into the program.

23. How much good does it do? In an average month at KU, the DAP Fills approximately 350-400 prescriptions for patients already established in the program. Currently we have approximately 300 patients active in the patient assistance program. Meet individually with about 20-25 new patients referred to the program For the first six months of 2005 we have received $483,103.50 worth of free medication for patients