Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum.
This week’s question is inspired by the forum topic “Could US Gov’t Probe Threaten Pharma Patient Assistance Programs?” from Oct. 12, 2018.
What are pharma patient assistance programs?
Pharma patient assistance programs (PAPs) generally refer to formalized arrangements patients make with specialty medication manufacturers — usually with the help of their treating physicians — to offset therapy costs.
Why seek a pharma PAP?
A recent retrospective, population-based study published in the journal Multiple Sclerosis and Related Disorders examined rising cost trends for disease-modifying therapies (DMTs). Researchers determined that annual medical costs for people with multiple sclerosis (MS) saw exponential increases between 2011 and 2015 “almost entirely due to the cost of DMTs.”
Research published by the National Multiple Sclerosis Society (NMSS) reveals that annual costs for DMTs in 2019 are close to six figures. Examples include Betaseron (interferon beta 1b) at $98,759, Rebif (interferon beta-1a) at $98,899, and Gilenya (fingolimod) at $99,896. The median yearly price of brand-name DMTs is $88,853.
Question: How do ordinary people afford this, given that the median U.S. household income in 2017 (the latest year statistics are available) was just over $60,000?
Answer: Pharma PAPs.
Who benefits from a pharma PAP?
Any person with MS who has a doctor’s prescription for a DMT can apply for a pharma PAP. Each manufacturer has its own tailored program to reduce copays, with some private charities also offering funding assistance.
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