Private Initiative Solves Drug Access Problems

Prescription drugs not only improve health and save lives--they can save money by reducing the need for expensive surgery or other costly treatments. One of the more hotly debated questions in health care policy today is how to ensure that price is no barrier to the necessary use of prescription drugs.

Most Americans have relatively little trouble affording the drugs they need. Drug coverage is included in most employer-provided health insurance plans, which cover more than 60 percent of working Americans and their families. In addition, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 added a prescription drug benefit to the Medicare program for retirees.

Prescription drug prices typically pose a problem only to those without health insurance, and to a small number of people with health insurance that doesn’t include a drug benefit. A recent report from the Kaiser Family Foundation, the October 2004 Prescription Drug Trends Update, reported, “37 percent of the uninsured said they did not fill a prescription because of cost, compared to 13 percent of the insured.”

Drugs Available for Needy

For the needy who might not otherwise be able to afford necessary medications, prescription assistance programs offered by pharmaceutical companies are filling a vital need.

For years, pharmaceutical manufacturers have offered programs to provide low-income individuals with drugs at either a low price or no cost at all. For example, Pfizer has had programs for more than 30 years to ensure their drugs are available to those in need.

Pfizer currently has several different programs to provide free or reduced-price drugs, each targeted to different groups who may have difficulty paying for their prescriptions. Pfizer Pfriends™, for example, offers steep discounts on drug prices to anybody who does not have prescription drug coverage, regardless of age and income.

Another Pfizer program, Connection to Care™, provides drugs free of charge to low-income individuals and families that do not have prescription drug coverage. Pfizer also offers several programs for free and reduced-cost drugs to people suffering from chronic conditions such as AIDS, cancer, or heart failure.

Help Is Used Widely

Bridges to Access™, GlaxoSmithKline’s program, provides drugs to low-income individuals and families who lack prescription drug coverage. In 2004, Bridges to Access™ gave away $372.5 million in drugs to 47,000 patients.

Another successful program is Abbott Laboratories Patient Assistance Program™, established in 1998. Abbott offers a Medicare Assistance Program specifically targeted at low-income senior citizens who need help paying for their drugs. More than 600,000 patients have received free or reduced-cost drugs since 1998, and Abbott estimates about 30 million of the 45 million uninsured could be eligible for assistance through its programs.

Other manufacturers with drug programs include Eli Lilly, Johnson & Johnson, AstraZeneca, Bristol-Myers Squibb, and Bayer.

One-Stop Shopping Available

Until recently, however, a patient needing several different medications from several different companies did not have an easy way to conveniently access all the necessary programs.

That shortcoming has been addressed, with the introduction of clearinghouses that connect consumers and manufacturers through a toll-free number and Internet site. The most recent effort to provide “one-stop shopping” for prescription drug assistance is the Partnership for Prescription Assistance™, a program sponsored by the Pharmaceutical Research & Manufacturers of America (PhRMA), American Academy of Family Physicians, National Association for the Advancement of Colored People, and others.

Partnership for Prescription Assistance™, launched in April, serves as a “single point of access to more than 275 public and private patient assistance programs, including more than 150 programs offered by pharmaceutical companies” according to its Web site. Many of the participating programs offer prescription drugs for free or for a minimal co-payment.

Millions of People Eligible

Another program aiming to simplify the process for those in need, the Together Rx Access Card™, began enrolling consumers in January. It is designed to allow most uninsured individuals and families to save approximately 25 to 40 percent on drugs they purchase directly at their local pharmacy.

Eleven of the world’s leading pharmaceutical companies participate in Together Rx Access™: Abbott Laboratories, AstraZeneca, Aventis Pharmaceuticals, Bristol-Myers Squibb Company, GlaxoSmithKline, Janssen Pharmaceutica Products L.P., Novartis Pharmaceuticals Corporation, Ortho-McNeil Pharmaceutical Inc., Pfizer Inc, Takeda Pharmaceuticals North America Inc., and TAP Pharmaceutical Products Inc. (Janssen Pharmaceutica Products and Ortho-McNeil Pharmaceutical are both part of the Johnson & Johnson family of companies.)

Uninsured individuals and families who meet generous income guidelines are eligible for Together Rx Access™. For example, an individual with an annual income of $30,000 or less is eligible, as is a family of four with annual income of $60,000 or less. An estimated 36 million people, or 80 percent of the uninsured, qualify for this program.

Some drug assistance programs are focused on specific states. One such program is Rx for Illinois, which describes itself as a “sister” organization to the Partnership for Prescription Assistance™.

Within a few months of its launch on November 9, 2004, Rx for Illinois had received more than 500,000 inquiries about eligibility. Nearly half of the people applying were deemed eligible for free or discounted drugs.

State-Run Program Flopped

The success of Rx for Illinois is particularly impressive when compared against I-Save-Rx, a program established by the state of Illinois to import drugs illegally from countries with price controls. The program was launched in October 2004 and has since expanded to include residents of Kansas, Missouri, Vermont, and Wisconsin.

Despite significant publicity surrounding the program, the Associated Press reported in an April 24 article that barely 6,300 people had used I-Save-Rx, which offers savings of up to 50 percent on prescription drugs.

The private-sector programs typically rely on local partners to promote the availability of prescription drug assistance. For example, the Rx for Illinois program works with the AIDS Foundation of Chicago, Community Nurse Health Association, Illinois Pharmacists Association, and local chapters of the American Lung Association and American Liver Association, among others.

Increasing Success

In 2004, prescription assistance programs run by pharmaceutical companies helped millions of Americans to fill 22,119,664 prescriptions with a total value of $4.17 billion, according to PhRMA. That was a marked increase over the previous year, when approximately 18 million prescriptions worth $3.4 billion were filled.

PhRMA President Billy Tauzin credits greater efforts to promote industry prescription assistance programs, as well as the creation of clearinghouses that allow patients to go to a single place to access more than 250 programs. “We hope the number of people who are helped continues to grow,” Tauzin said. “Medication that sits on a shelf, out of financial reach of patients, helps no one.”

Sean Parnell (parnell@heartland.org) is vice president of The Heartland Institute.