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Home > About MS > Prescription Assistance Programs
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Prescription Assistance Programs

Prescription Assistance Programs for MS Disease-Modifying Therapies

Aubagio

Program name: MS One 2 One
Phone: (855) 676-6326
Website: www.aubagio.com

MS One 2 One will assist patients in the following ways:

  1. Individuals with no insurance, or with only Medicare part A and B (but not D), may register for the Patient Assistance Program (PAP). Eligible individuals must be a United States resident with a Social Security number. The household income must also be less than or equal to $100,000. If qualified, the eligible individual will have no out of pocket expense. Program participants must reapply each year. As noted earlier, individuals with Medicare part A and B may apply for assistance; individuals with part D are not eligible.

  2. For individuals with private insurance, co-pay assistance is available. If eligible, the applicant will receive the first three months at no cost. For every month thereafter until 12 months, the co-pay is $35. Program participants must reapply each year. Although there is no financial limit for income, only individuals with private insurance may apply.

*Patients covered by federal and state healthcare programs are not eligible for assistance (excluding individuals on Medicare without part D who are otherwise eligible under the PAP program).


Avonex

Program name: MS ActiveSource
Phone: (800) 456-2255
Website: www.avonex.com

MS ActiveSource will assist patients in the following ways:

  1. Most individuals with private insurance will be eligible for a $0 co-pay assistance program. There are no income requirements for the program; however, income information will need to be provided in order to enroll. Individuals on Medicare who need assistance can call in to speak with a representative about other ways to receive help.

  2. Individuals will need to re-enroll in the patient assistance program every year.

  3. Uninsured individuals may be eligible to receive Avonex for free; there is an undisclosed financial criterion.

*Federal and state laws may prevent eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. In addition, some insurance providers may prevent eligibility or restrict eligibility to people with demonstrated financial need. If you are not eligible or not sure of your eligibility, please call 1-800-456-2255.


Betaseron

Program name: BetaPlus
Phone: (800) 788-1467
Website: www.betaseron.com

BetaPlus will assist patients in the following ways:

  1. For individuals with no insurance, or if they have Medicare Part D, they can apply for the Patient Assistance Program. If they are approved, they can receive a three-month supply for a variable participation fee . There is an undisclosed financial eligibility criterion. This will continue for one year, at which time they can reapply. If they are not eligible at this time, they will be referred to a list of agencies for assistance.

  2. If they have insurance, they can receive co-pay assistance up to $14,500 yearly. Patients will have no co-pay expense until they reach the maximum assistance limit of $14,500 yearly. There are no household income restrictions for this program.

  3. If an individual with private insurance is currently taking Betaseron but the insurance provider drops coverage of Betaseron they may qualify for the Beta Bridge program. The Beta Bridge is a program that provides access to Betaseron at no cost to the patient for up to 12 months (subject to change). This program is only open to current Betaseron users with private insurance coverage and does require enrollment. To learn more, contact the BetPlus hotline, and let your doctor know you do not want to change medications and want to appeal the insurance denial.

*Patients who are enrolled in any type of government insurance or reimbursement programs are not eligible.


Copaxone

Program name: Shared Solutions
Phone: (800) 887-8100
Website: www.copaxone.com

Shared Solutions will assist patients in the following ways:

  1. Individuals with no insurance are referred to Assist RX. The Shared Solutions case manager will conference-call with the patient and the Assist RX organization. The information about eligibility is not public. An individual's cost would be zero for one year. He or she will then need to reapply. If not eligible at this time, there is no further assistance.

  2. If a person is on Medicare, the Medicare Team, working with a specialty pharmacy (ACS) will pay through the coverage gap. This program is ongoing.

  3. For people with private insurance, the Co-Pay Solutions program will assist. Co-pay amounts based on a sliding scale. This program is ongoing.

*The offer is not valid for patients covered in whole or in part by Medicaid, Medicare, TRICARE, or any other federal or state government pharmaceutical assistance plan or program (regardless of whether a specific prescription is covered), or by private health benefit programs that reimburse for the entire cost of prescription drugs.


Extavia

Patient Services Program
Phone: (866) 398-2842
Website: www.extavia.com

Extavia's Patient Services Program will assist patients in the following ways:

  1. For individuals with no insurance, they can receive free medication if their income is less than five times the Federal Poverty Level (which increases based on the number of people living in the household), under the Novartis Patient Assistance Foundation. The benefit continues for one year, at which time the patient may reapply. If there is an alternative program, the patient will be referred.

  2. For individuals who have insurance with a high co-pay, they can receive assistance if they are financially eligible. This is also true if they have Medicare and need help with the coverage gap.

Both of these programs require that the patient reapply after one year. If the patient is no longer eligible at this time, referrals are made to other agencies.

*The EXTAVIA Co-Pay Program offer is not valid for prescriptions for which payment may be made in whole or in part under federal or state health programs, including but not limited to Medicare or Medicaid, or for residents of Massachusetts.


Gilenya

Patient Services Program
Phone: (800) 445-3692
Website: www.gilenya.com

Gilenya's Patient Services Program will conduct a benefits investigation and determine on an individual basis what assistance a person may be eligible to receive. The program will assist patients in the following ways:

  1. For individuals with no insurance, they can receive free medication if their income is less than five times the Federal Poverty Level (which increases based on the number of people living in the household), under the Novartis Patient Assistance Foundation. The benefit continues for one year, at which time the patient may reapply. If there is an alternative program, the patient will be referred.

  2. For individuals with commercial insurance, they can receive help up to $12,000 yearly under the Pharmacy Co-Pay Support Program. This program is based on the present calendar year. The amount of assistance received will depend on the co-pay amount; not everyone will receive $12,000 per year. The program does not apply for individuals who may receive payment under federal or state health insurance programs such as Medicare or Medicaid.

Please note that certain states are not covered under these programs. Individuals living in those states need to ask the Patient Services representative about other assistance.

In addition to medication co-pay assistance, the Gilenya Go Program also offers the Medical Co-Pay Support program. This latter program provides financial assistance for eligible individuals to help pay costs associated with medical testing needed before an individual can begin treatment on Gilenya. An eligible individual will pay the first $125 of the needed medical co-pay and the Medical Co-pay Support program will pay up to the next $600 of the co-pay.

Please note that this program only applies to individuals who have not yet started taking Gilenya. Additionally, it is not valid for medical testing that is covered under any federal or state health programs (such as Medicare or Medicaid). The Medical Co-Pay Support program excludes residents of Massachusetts, Michigan, and Rhode Island.


Plegridy

Program name: MS ActiveSource
Phone: (800) 456-2255
Website: www.plegridy.com

MS ActiveSource will assist patients in the following ways:

  1. Most individuals with private insurance will be eligible for a $0 co-pay assistance program. There are no income requirements for the program. Depending on your income or, in some cases, if your medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that you can receive over one year.

  2. Individuals on Medicare who need assistance can call in to speak with a representative about other ways to receive help.

  3. Individuals will need to re-enroll in the patient assistance program every year.

  4. Uninsured individuals may be eligible to receive Plegridy for free; there is an undisclosed financial criterion.

*Federal and state laws may prevent eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. In addition, some insurance providers may prevent eligibility or restrict eligibility to people with demonstrated financial need. If you are not eligible or not sure of your eligibility, please call (800) 456-2255.


Rebif

Program name: MS Lifelines
Phone: (877) 447-3243
Website: www.mslifelines.com

MS Lifelines will assist patients in the following ways:

  1. If a person has no insurance or lacks drug coverage he or she will be provided with free medication for up to one year, under the Access Made Simple program. At that time, the patient may reapply and is often still eligible. There is no financial limit for this program.

  2. If a person is insured he or she may be eligible to receive Rebif for a $0 co-pay. The Financial Support Team at MS Lifelines determines program eligibility.

*Please note that individuals who receive health insurance through state or federal government healthcare programs are not eligible for assistance through this program.


Tecfidera

Program name: MS ActiveSource
Phone: (800) 456-2255
Website: www.tecfidera.com

MS ActiveSource will assist patients in the following ways:

  1. Most individuals with private insurance will be eligible for a $0 co-pay assistance program. There are no income requirements for the program. Depending on your income or, in some cases, if your medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that you can receive over one year.

  2. Individuals on Medicare who need assistance can call in to speak with a representative about other ways to receive help.

  3. Individuals will need to re-enroll in the patient assistance program every year.

  4. Uninsured individuals may be eligible to receive Tecfidera for free; there is an undisclosed financial criterion.

*Federal and state laws may prevent eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. In addition, some insurance providers may prevent eligibility or restrict eligibility to people with demonstrated financial need. If you are not eligible or not sure of your eligibility, please call (800) 456-2255.


Tysabri

Program name: MS ActiveSource
Phone: (800) 456-2255
Website: www.tysabri.com

MS ActiveSource will assist patients in the following ways (the guidelines are the same as for Avonex):

  1. Most individuals with private insurance will be eligible for a $0 co-pay assistance program. There are no income requirements for the program; however, there may be an annual cap that limits the amount of assistance that you can receive over one year, based on income.

  2. Individuals on Medicare who need assistance can call in to speak with a representative about other ways to receive help.

  3. Individuals will need to re-enroll in the patient assistance program every year.

  4. Uninsured individuals may be eligible to receive Tysabri for free; there is an undisclosed financial criterion.

Individuals may also receive assistance from Biogen for certain infusion-related costs.

*Federal and state laws may prevent eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. In addition, some insurance providers may prevent eligibility or restrict eligibility to people with demonstrated financial need. If you are not eligible or not sure of your eligibility, please call 1-800-456-2255.




Prescription Assistance Programs for Treating Relapses

Acthar Gel

Program name: Acthar Support and Access Program (ASAP)
Phone: 1-888-435-2284
Website: www.actharmsrelapse.com/acthar-support-services/get-reimbursement-support-and-more.html

Acthar Support and Access Program (ASAP) will assist patients in the following ways:

  1. For uninsured or underinsured patients, there is an undisclosed financial criterion; if eligible, individuals will receive a free shipment of Acthar for the current relapse.

  2. For patients with insurance, this program will assist patients in applying for co-payment assistance. Patients will be notified of the expected co-payment before Acthar shipment is made.

IV Solu-Medrol

Solu-Medrol is a high dose of corticosteroids given by intravenous (IV) infusion in an inpatient or outpatient setting. This drug is not currently patented, so multiple brands (including generic brands) are available and these do not offer patient-assistance programs. Individuals will need to check with their insurance provider regarding coverage in an inpatient or outpatient setting. Uninsured individuals should check with the facility providing the infusion to see if it offers a financial-assistance program.

*Sometimes it may be decided that pulse steroids or an oral taper of steroids are needed after an initial dose of IV Solu-Medrol.


Intravenous Immunoglobulin Replacement Therapy (IVIG):

IVIG is an experimental relapse treatment given by IV infusion. Individuals with insurance should check with their insurance provider to see if this is covered. Uninsured individuals should check with the facility providing the infusion to see if it offers a financial-assistance program.

*The Jennifer Jaff Center is an organization that offers chronic illness advocacy:
IVIG Patient Resource Center for individuals who have been prescribed IVIG and insurance denies the claim.


Plasmapheresis (Plasma Exchange):

An experimental process sometimes used when relapse treatment with steroids has not been effective. Blood is removed from the body, plasma is removed from the blood, and the remaining red and white blood cells are circulated back into the body. This procedure is performed in a medical setting. Individuals will need to check with their insurance provider to see if this is a covered procedure. Uninsured individuals should consult with the facility where they will receive plasma exchange to see if the facility offers a financial-assistance program.




Prescription Assistance Programs for MS Symptom Management

Bladder Problems

  • Ditropan XL

Johnson and Johnson Patient Assistance Foundation
Phone: (800) 652-6227
Website: www.jjpaf.org/how-we-help/index.html

  1. Insured (including Medicare, Medicaid, and Medicare Part D recipients) -- For individuals who fall within income guidelines and whose insurance does not cover the prescription, they must demonstrate significant financial hardship to qualify.

  2. Uninsured -- Individuals who fall within the income guideline (typically 200 percent of the federal poverty level) will generally be eligible for assistance. If eligible, a person may receive the medication at no charge for up to one year, and then he or she must re-apply.
  • Dibenzyline

Wellspring Pharmaceutical Patient Assistance Program
Phone: (908) 203-3791
Website: www.wellspringpharm.com/commitment-patient-assistance.html

Insured and uninsured -- Individuals must document that they have no prescription drug coverage and must meet an undisclosed eligibility criteria to qualify. If approved, a three-month supply of the medication will be shipped to their physician.

  • Cipro

Bayer Healthcare Pharmaceuticals Patient Assistance Program (through RxAssist)
Phone: (866) 575-5002
Website: www.rxassist.org/

Insured and uninsured -- Individuals must document that they have no prescription drug coverage and must meet an undisclosed eligibility criteria. No one on a government-sponsored insurance program (including Medicare or Medicaid) may apply. If approved, a three-month supply of the medication will be shipped to the individual.


Cognitive Problems

  • Aricept

Eisai Primary Care Assistance Program (through RxAssist)
Phone: (800) 226-2072
Website: http://us.eisai.com/product.asp?ID=168

Insured or uninsured (including Medicare) -- An individual must document that he or she has no prescription drug coverage and must fall within 200 percent of the federal poverty level to qualify. If approved, a three-month supply of the medication will be shipped to the person's physician. Individuals must re-apply for the program every 12 months.


Depression

  • Effexor

Please see Pfizer RxPathways at the end of this listing.

  • Celexa
  • Lexapro

Please see Forest Pharmaceuticals Patient Assistance Program at the end of this listing.

  • Prozac

Please see Lilly Cares and LillyMedicareAnswers at the end of this listing.

  • Wellbutrin

Phone: (800) 548-5100, option 1
Website: www.wellbutrinxl.com

Patient support programs include the following:

Co-Pay Savings Program - Individuals who are insured as well as those who are uninsured (excluding any government-sponsored insurance such as Medicaid and Medicare) may print a coupon to pay an initial $4 toward the cost of the medication. The coupon then pays up to the next $50 of the medication costs. The coupon can be used up to 12 times.


Fatigue

  • Provigil
  • Nuvigil

TevaCares Foundation
Phone: (877) 237-4881
Website: www.cephaloncares.com

Uninsured -- Individuals within 300 percent of the federal poverty level and approved through the program will receive the medication free of charge.


Pain

  • Lyrica
  • Dilantin
  • Cytotec

Please see Pfizer RxPathways at the end of this listing.

  • Depakote

Partnership for Prescription Assistance Phone: (888) 477-2669
Website: www.pparx.org

  1. Insured -- Individuals pay the first $5 of their co-payment for a qualified prescription; the discount card covers up to the next $75 off of the remaining co-pay expenses. The discount card can be used up to two times per month.

  2. Uninsured or self pay -- Individuals may print a coupon to pay the first $5 of their prescription and the coupon will pay up to the next $75 of the remaining medication costs.

Pseudobulbar Affect

  • Nuedexta

Phone: (855) 4NUEDEX (468-3339)
Website: www.nuedexta.com

Patient support programs include the following:

  1. Private insurance -- Individuals who are within 200 percent of the federal poverty level may qualify for the co-pay assistance program. This will reduce their co-pay to no more than $30 per medication refill.

  2. Medicare Part D -- Individuals may be able to qualify for co-payment through an assistance program.

  3. No insurance or no prescription coverage -- Individuals who are within 200 percent of the federal poverty level may be able to receive the medication for free through a voucher program.

Please note that patients must re-apply for prescription assistance each year.


Sexual Dysfunction

  • Viagra

Please see Pfizer RxPathways at the end of this listing.

  • Cialis

Please see Lilly Cares and LillyMedicareAnswers at the end of this listing.


Spasticity

  • Botox

Phone: (800) 44-Botox (442-6869), option 4
Website: www.botoxreimbursement.us/pap.aspx

Patient support programs include the following:

  1. Botox Partnership for Access - Individuals with private insurance (excluding Medicaid, Medicare, and any other government healthcare program) may receive up to $100 (on a pre-paid card) per Botox treatment to assist with co-pay fees. This program only applies if an individual's insurance will cover the procedure.

  2. Botox Prescription Assistance - Individuals who are uninsured or whose insurance does not cover Botox may qualify if they fall within 300 percent of the federal poverty level. If approved, the medication would be shipped for free to their doctor's office. Individuals must use the request form to obtain a new shipment every three months. Please note that this program only covers the cost of the Botox medication for eligible individuals and does not cover any other fees associated with the injection, which may be billed by the physician.



Pharmaceutical Company Programs for More than One Medication

Forest Pharmaceuticals Patient Assistance Program

Phone: (800) 851-0758
Website: www.forestpharm.com/pap/

  • Celexa (depression)
  • Lexapro (depression)
  1. Insured and uninsured -- Individuals who meet the undisclosed income guidelines will be shipped a three-month supply of their medication at no charge. If an individual still needs assistance after three months, he or she must re-apply.

  2. Medicare Part D -- In most circumstances, people with Medicare Part D must apply for and be denied "Low Income Subsidy" (LIS) by the Social Security Administration before qualifying.

Lilly Cares and LillyMedicareAnswers

  • Cialis (sexual dysfunction)
  • Prozac (depression)
  1. Lilly Cares -- Individuals who are uninsured or have no prescription drug coverage may qualify if their income falls within 300 percent of the federal poverty level. A 120-day supply of the medicine is shipped out and refills are available for one year.
    Phone: (800) 545-6962
    Website: www.lillytruassist.com/Pages/AboutLillyCares.aspx

  2. LillyMedicareAnswers -- Individuals must be enrolled in a Medicare Part D program and must be denied or otherwise ineligible for the "Low Income Subsidy" (LIS) offered through the Social Security Administration (SSA). Income must fall within 300 percent of the federal poverty level to qualify.
    Phone: (877) 795-4559
    Website: www.lillytruassist.com/pages/AboutLMCA.aspx

Pfizer RxPathways

Phone: (866) 706-2400
Website: www.pfizerrxpathways.com

  • Cytotec (pain)
  • Dilantin (pain)
  • Effexor (depression)
  • Lyrica (pain)
  • Viagra (sexual dysfunction)
  1. Prescription coverage -- Income must fall within 200 percent of the federal poverty level to qualify. For individuals who cannot afford his or her coinsurance or has been denied coverage for the medication, assistance may be requested. In some cases, patients who apply for free medicine and have private insurance coverage may even receive co-pay assistance* through Pfizer RxPathways. Instead of having free medicine shipped to them, these patients will receive a Pfizer RxPathways co-pay card to use at their local pharmacy to cover the entire cost of their co-pay.

  2. No prescription coverage -- An individual's income must fall within 200 percent of the federal poverty level to qualify. If eligible, the medication is mailed to the prescribing physician's office.

*Patients who participate in any federal or state programs, such as Medicaid or Medicare, are not eligible for co-pay assistance. However, these patients may be eligible to receive their medicine for free through Pfizer RxPathways. Terms and conditions apply.

Please note: The information in this listing has been gathered from each pharmaceutical company separately and may be subject to change. For program specifics, please contact the corresponding patient services program. MSAA does not endorse any specific brand, treatment, or program and is not responsible for any unintentional errors in program descriptions, changes to a specific program and its limitations, acceptance into a program, or any financial assistance. Other programs may exist that have not yet been included on this list. For additional information, please call MSAA's Helpline at (800) 532-7667.
Last Updated on Monday, 24 November 2014 12:50