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Patient Assistance Programs Overview

Patient Assistance Programs Overview. Virginia Department of Health HIV Care Services Unit November 2010. Objectives. Describe how to help clients navigate and access these programs.

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Patient Assistance Programs Overview

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  1. Patient Assistance Programs Overview Virginia Department of Health HIV Care Services Unit November 2010

  2. Objectives • Describe how to help clients navigate and access these programs. • Understand what Patient Assistance Programs (PAPs) are, the various eligibility requirements, and how to use them. • Identify medication access options during current AIDS Drug Assistance Program (ADAP) funding crisis.

  3. PAPs-What are they? • PAPs provide free or low-cost drugs to individuals who cannot otherwise afford them. • There are multiple options and companies. • Each pharmaceutical company has specific criteria and eligibility requirements for each program.

  4. What’s next? How do I get medications? • First Step – Refer all clients to Patient Services Inc. (PSI) to apply for ADAP, verify eligibility, and place on waitlist if appropriate. • Who can access PAPs? • A physician can register as a provider • An individual can enroll on their own; however they will still need information from their provider/physician 1-866-392-1309

  5. Resource tool • Resource tool provides information from all PAPs including non-antiretrovirals (non-ARVs) removed from the formulary: • Drug company/drug • Eligibility • Turnaround time • Medication delivery method • Refill method • Length of enrollment

  6. Application Overview • All applications will require: • Patient name, address, phone, date of birth • Provider name, address, phone, fax, drug enforcement agency number (DEA) • Prescription information • Financial information • Insurance information (Y/N, ADAP waitlist)

  7. Overview of Low Cost Generics • A list of available low cost generics for medications that have been removed from the ADAP formulary has been compiled. (see resource tool). • Low cost generic medications are available at several retail pharmacies throughout the state and cost approximately $4 each for a 30-day supply.

  8. If a patient is denied for ADAP, could they be eligible for other Ryan White (RW) services? • Potentially, denied clients may be eligible for core and support services and are encouraged to apply for RW. • However, RW Part B funds may not be used for the financial support of medications removed from the ADAP formulary. • Please note: if a client is denied for ADAP, RW Part B funds cannot be used to purchase medications on the ADAP formulary.

  9. Challenges • Client may be on multiple medications from different drug companies. May be delivered at different times. • Some drugs may be delivered to patient, some may be delivered to provider. A card/voucher may also be sent to the client. • ADAP stakeholders have a variety of experience utilizing PAPs.

  10. Tips for a smooth application process • Review the application and make sure it is complete and that all documents are attached. • Keep a copy of application package for your records. • Follow instructions for each program since they are all different. • Follow up with the company if you do not hear from them in 2-3 weeks.

  11. Who do I contact? • Each pharmaceutical company has individual requirements for PAPs; it is best to contact each company directly. • Most companies have a designated website or toll-free number to receive information regarding PAPs.

  12. Lessons Learned from other states using PAPs • Educate stakeholders as early as possible on PAP process and medication access. • Develop comprehensive tool with PAP resources for antiretrovirals (ARVs). • Encourage case managers to communicate with the local health department ADAP staff and vice versa. • Include links to PAPs on ADAP website.

  13. PAP Resources • NeedyMeds- http://www.needymeds.org/ (also for HCV drugs and vaccines) • Partnership for Prescription Assistance- http://www.pparx.org/ • RxAssist Patient Assistance Program Center- http://www.rxassist.org • RxHope- https://www.rxhope.com/home.aspx

  14. Virginia Health Care Foundation (VHCF) • Provides medication assistance through free and community health clinics across Virginia. • Utilizes a software program that finds PAPs for all of patient’s medications • www.vhcf.org

  15. Other Patient Assistance Programs • Welvista Patient Assistance- http://www.welvista.org/adap_how.php • Covers six ARVs (Abbott, Merck & Tibotec)-Norvir, Kaletra, Isentress, Crixivan, Prezista and Intelence • Only available for clients who are currently on a waiting list for a state ADAP.

  16. Other Resources • www.HIVCaseManager.com • A free, innovative online resource directory designed to help front-line HIV service providers meet their client education needs. • Links to more than 200 national, state and city HIV/AIDS organizations and resources.

  17. Additional information needed? Please contact: ADAP Coordinator: Rachel Rees 804-864-7919 Rachel.Rees@vdh.virginia.gov ADAP Operations Specialists: Jennifer Flannagan 804-864-7360 Jennifer.Flannagan@vdh.virginia.gov Or Kate Cooke 804-864-8019 Kate.Cooke@vdh.virginia.gov Or HIV/STD/Viral Hepatitis Hotline 1-800-533-4148

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