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:
- How easy is it to apply?
- What is needed to apply?
- How easy is it to receive the assistance?
- Do they really work in terms of helping MS patients with financial assistance?
- 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.
*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.