Analyzing Patient Assistance Programs for Multiple Sclerosis: AVONEX and AVONEX Services

As part of our continuing efforts to highlight all the patient assistance programs available through the pharmaceutical companies that make the disease modifying drugs for Multiple Sclerosis, we continue with AVONEX. The price of AVONEX is approximately $3,000 per month.

What we want to know about these programs is:

1. How easy is it to apply?
2. What is needed to apply?
3. How easy is it to receive the assistance?
4. Do they really work in terms of helping MS patients with financial assistance?
5. What is offered?

AVONEX offers a program called AVONEX Services that covers a co-pay program and an access program. The only way to apply to these programs is via a phone call to them at 1-800-456-2255. There is no online application. From the phone call I placed to AVONEX Services, it seems that a prelimary phone interview is the way to get things rolling, where certain information is taken from you and then turned over to their financial assistance team. You must have a prescription for AVONEX to begin the process.

If you have insurance and cannot meet your co-pay, their financial assistance team will do insurance research to see if you do have coverage for the drug. If you still cannot afford your co-pay, a 2nd screening is done by the AVONEX Services financial assistance team. Eligibility, I was told, is done on a case-by-case basis.

I did not receive a clear answer on what the qualifiers are for the programs and I have asked them to contact me further so I can post them here.

As far as being underinsured or uninsured, AVONEX Services offers something called their access program. Again, details remain sketchy but I came away from my conversation with AVONEX Services with these points:

• They do help those who are on government assistance.
• They do help both new and current AVONEX users.
• They do offer a temporary assistance program, of up to two (2) years, to get those who need AVONEX free of charge.

Beyond that, I am not certain on a few other issues. For example, it was said several times that “they partner with financial institutions,” to help you with payment. When asked what financial institutions they partner with, I was told that information comes from the financial assistance team. Again, it is unclear to me what that means.

Sending MS patients to charitable organizations to get their AVONEX was also mentioned, but that was it; it was mentioned with no further details. Why they would mention a program to send patients to charitable organizations when they have a program in place for up to two (2) years, leaves the overall impression of gaps within their patient assistance program. Again, I am waiting for more details from AVONEX.

I finally inquired about the Affordable Care Act and the impending six (6) month waiting period to apply for the new high risk pools and what, if anything, was Biogen doing about this. Are they prepared for this and would they be willing to begin a program that will get this group of people their drugs for free? I left my contact information and I await their response.

AVONEX is manufactured by Biogen Idec who also make Tysabri. Stock quote for Biogen can be found here.

Analyzing Patient Assistance Programs for Multiple Sclerosis: MS LifeLines and Rebif

As part of our continuing efforts to highlight all the patient assistance programs available through the pharmaceutical companies that make the disease modifying drugs for Multiple Sclerosis, we continue with Rebif.

What we want to know about these programs is:

1. How easy is it to apply?
2. What is needed to apply?
3. How easy is it to receive the assistance?
4. Do they really work in terms of helping MS patients with financial assistance?
5. What is offered?

We finally got some good news and welcome answers today when we spoke with MS LifeLines. For those of you with MS who are uninsured or underinsured, you can and do receive help. The application process must begin over the telephone and can, most times, be completed by phone with no waiting period. There is no online application. The phone number for MS LifeLines is 877-447-3243.

You must have a valid prescription for Rebif to start the process. Rebif costs approximately $2800 per month. More drug information can be found at Destination Rx.

MS LifeLines offers three types of assistance, including help for those who are currently taking the medication. The chart below is taken directly from MS LifeLines and explains the assistance for those who are newly prescribed and those who are currently taking Rebif.

I asked if MS LifeLines was prepared for the fact that many will be asking for assistance due to the stipulation of going without insurance for 6 months prior to applying to the new high risk pools and indeed, could they be receive Rebif at no charge? The answer was yes, and yes, they already do offer assistance of free medication, up to one year, for those without insurance. MS LifeLines also stressed to me the importance, they feel, of making sure those who do need Rebif and cannot afford it, do get help, including the Medicare Part D “Donut Hole.”

Rebif is made by EMD Serono, Inc., an affiliate of Merck KGaA, and by Pfizer Inc. Stock quote for Merck here. Quote for Pfizer here.

Analyzing Patient Assistance Programs for Multiple Sclerosis: Shared Solutions and Copaxone and Update*

The Foundation will be highlighting all the patient assistance programs available through the pharmaceutical companies that make the disease modifying drugs for Multiple Sclerosis.

What we want to know about these programs is:

1. How easy is it to apply?
2. What is needed to apply?
3. How easy is it to receive the assistance?
4. Do they really work in terms of helping MS patients with financial assistance?
5. What is offered?

We started first with Copaxone, a daily injectable made by Teva.

Teva Neuroscience, has a patient assistance program called Shared Solutions. I called them today to find out what assistance they may offer in helping MS patients pay for Copaxone, especially those who do not have insurance and specifically, the group of people who must go without insurance before first applying to the new high risk pools.

The answers I received were disappointing and upsetting.

First, the cost of Copaxone per month is, according to Shared Solutions, anywhere from $3500 to $3700 per month.  Not sure why there is a $200 discrepancy as that was not clear to me.

Second, they do not offer an online application process, you must call and request an application. Now if you want to apply to be part of Team Copaxone (a marketing arm for Teva) then you can apply online. More information is here.

But back to Shared Solutions. The terms of acceptance for their financial assistance were not given over the phone as they had to look at each application.

Next, they only offer a $50 copay to help you if you are insured with a group or private plan. Knowing full well some people receive paltry co-pays on their prescription drug coverage, the $50 copay assistance is insulting. And considering the daily cost of Copaxone at $3500 per month which comes out to $117 per day, the copay does not cover the full cost of one injection!

Also, they do not help anyone who receives government assistance as that “is not our company policy.” That was the answer Shared Solutions gave me when I asked why they do not help those who receive government assistance.

Disappointed with the answers I received, I did request that Shared Solutions contact me regarding implementing a program to give out the drugs for free for those who need them for the six months before this certain group of MS patients can apply to the new high risk pools. This Foundation would be willing to work with Shared Solutions to get MS patients their much-needed therapies. It’s in Shared Solutions court right now. Here is the Copaxone link and the link for Insurance Assistance for Copaxone.

From their website:

If you do not have insurance or if you need help paying for COPAXONE®, Shared Solutions® can refer you to other financial assistance programs.

And so it was I was referred to their other financial assistance program, Assist-Rx. Assist-Rx has taken over for NORD. While they were as helpful as possible, Assist-Rx has been overwhelmed with applications and is simply at a standstill. Their number is 877-422-4412. Being inundated with applications, as I was told by Assist-Rx, obviously proves the need for payment relief and the need for more coordinated efforts on the part of MS patients. This Foundation is willing to step-up.

But we have another obstacle. Coverage for prescription drugs is left up to the health insurers and there are no provisions or regulations to help the consumer, even the ones who are well-insured, to make sure they can get affordable coverage. More information about the soaring costs of these drugs and their effectiveness here, here and here (this last one is a discussion but we too had the same reaction–how much less would it cost if they stop with all this expensive to-make and to-mail CD, DVD, calendar and other marketing promos they send out?)

So, what happens when you do not have insurance to cover all or part of your Copaxone, or your COBRA is about to run out and you still don’t have health benefits? What if you do not qualify for Medicaid or you are too young for Medicare? If you fall into one of those groups, then you have no place to turn.

This Foundation aims to change that.

Teva stock quote can be found here. More Teva information can be found here.

*Update, November 8, 2010: Shared Solutions contacted me today and we spoke about their patient assistance programs. They were unaware that Assist-Rx was overwhelmed with applications and said they would look into it further. They were not certain what, if anything, they would be doing regarding the Affordable Care Act and the 6-month waiting period prior to applying to the new high risk pool. In fact, I was told they were not fully certain of what the new law would bring, so I explained the guidelines for the high risk pool. I was told that my request to supply MS patients free of charge during this period, would be looked into by the people at Teva who can make those decisions. Also, please know that they do offer more extensive co-pay assistance than $50 per month, you must ask when applying.