Pharmaceutical Patient Assistance Programs: An Evaluation of the Availability and Eligibility Requirements for Brand and Generic Prescription Drugs

Background: With the high price of prescription drugs in the United States, pharmaceutical-sponsored patient assistance programs (PAPs) play an important role in the current health care system by providing free or low-cost medications to low-income and un/underinsured patients.

Methods: We searched an electronic database of PAPs from RxAssist.org for the availability (brand and/or generic) of and eligibility requirements (citizenship, permanent residency, income limits, insurance status) for the “Top 200 Drugs in the U.S. by dispensed prescriptions” in 2008. When clarification was needed on eligibility criteria, we searched individual pharmaceutical company websites or contacted their PAP staff by phone. We assessed associations between the brand versus generics and eligibility requirements using chi-square tests.

Results: Of 136 unique chemical entities, 111 (81.6%) were available through PAPs. Sixty-nine (62.2%) of the available drugs were brand only, 29 (26.1%) generic only and 13 (11.7%) had both brand/generic forms. There were differences found in PAP eligibility requirements for citizenship (p< 0.001), permanent residency (p< 0.001), and private insurance status (p< 0.001) by drug availability (brand versus generic), but not for income limits (p= 0.051). Some programs allow Medicare Part D patients to apply for PAP; however, each claim is evaluated on case-to-case basis.

Conclusions: Results suggest that most common prescription drugs are available through PAPs, but brand drugs are more likely to be offered to the citizens and legal residents of the U.S. than generics. There are also other PAP options for Medicare Part D beneficiaries; however, pharmaceutical companies often fail to disclose specific eligibility.