Jobs

Finding help for the high cost of prescription medicine

By Cindy Atoji Keene
Family medicine physician Rich Sagall has always been a firm believer in patient advocacy – not just making a diagnosis but supporting patients as they cope with the effects of their disease. He found that conditions such as heart disease or diabetes were often complicated by social issues, such as poor housing, access to healthy food, insurance coverage, and one of the biggest – inability to afford prescription drugs. In response, Sagall began developing a non-profit to help people who can’t afford their medications and health care costs. NeedyMeds was launched almost two decades ago and has since grown into a national resource with information on nearly 400 programs offering around 4,000 drugs. “Studies have shown that 30-50 percent of all prescriptions written are never filled – and the primary reason is cost,” said Sagall, who left his practice and devoted himself to the Gloucester-based NeedyMeds when he realized how much service it was providing to the uninsured, or underinsured – “those who are sometimes referred to as the working poor,” said Sagall.

Q: Patients can look up drugs on NeedyMeds, from ‘A’ –Abilify, a drug for schizophrenia, to ‘Z’ – Zaditor, an antihistamine eye drops. What’s the next step?
A: In the last six months, visitors to NeedyMeds looked up information on over 6,400 different drugs. This includes many pain medicines, psychoactive drugs, cardiac medicines, stomach medicines, diabetes drugs, and cholesterol lowering drugs. They can click on the name of the drug and see if there is a coupon or rebate available, or if the medication is available through a Patient Assistance Program. Many people don’t realize that pharmaceutical manufacturers have 
‘Patient Assistant Programs’ that give away billions of dollars of drugs every year to people that can’t afford their medications. These programs usually require a doctor’s consent, proof of financial status, and no insurance coverage for medications. Typically, if you’re approved, up to a year’s supply of medication is shipped directly to you or your physician.

Advertisement:

Q: How would you respond to critics who say that rather than just helping patients, assistance programs are actually aiding drug companies with profits, increasing demand and allow companies to charge higher prices?
A: These Patient Assistant programs cost the pharmaceutical companies a lot of money, between the cost of the medicine and the expense of running the program. It’s true that any increase in demand might benefit the companies if patients eventually obtain insurance coverage that cover their medicines. Like anything any business does, there are many motivating factors – some altruistic in nature and some more business-oriented. If you talk to those who benefit from these programs, though, you’ll find many grateful people.

Q: NeedyMeds has become a online clearinghouse to help people struggling with healthcare costs. What other information do you provide?

A: When I first started NeedyMeds, medical social workers often created their own databases of information on their laptops as they helped needy clients apply to pharmaceutical patient assistance programs. I realized there was a need for a central repository, not just on these programs but for drug cards and rebates; free or low cost clinics; state and local programs, and others. We have staffers who spend all their time gathering information about various programs and keeping it current, and the verifying the data. And there are close to 2,000 programs that assist based on diagnosis, disease or condition; for example, a chemotherapy patient may qualify for medically-necessary wigs; diabetics can get help with insulin supplies; even if you are so debilitated that you need transportation or help cleaning your house, there is help available.

Advertisement:

Q: In addition to NeedyMeds, there are many online healthcare resources – how can consumers know which ones are reliable?
A: It’s usually best to go with established groups such as Mayo Clinic or Johns Hopkins. The government website Healthfinder.gov is another great site.
It’s easier to give advice on sites to avoid. The first rule is to skip any site that is selling cures or talking about things “doctors don’t want you to know.” Avoid any sites that claim to have secret knowledge or make spectacular claims. You can’t go wrong if you follow the dictum “If sounds too good to be true then it probably is.

Jump To Comments

Conversation

This discussion has ended. Please join elsewhere on Boston.com