Dealing with a cancer diagnosis is difficult, and many patients are uncomfortable discussing financial matters with their doctors or other members of their healthcare team. Although some oncology practices have financial counselors on staff to meet with patients, others do not offer this service, leaving many individuals unaware of financial services that may be available to them.
Health insurance companies are increasingly expecting patients to pay a large part of the costs associated with their treatment. This is especially true for those with high deductibles or high insurance premiums. In some cases, health insurance companies simply do not offer coverage for certain expensive cancer drugs. This includes several drugs that are prescribed for mantle-cell lymphoma. For those in need, several types of patient assistance programs are available. These programs vary in terms of their eligibility requirements and the amount of financial support they can offer. Patient assistance programs can be grouped into the following types:
- Manufacturer copay programs (sometimes called copay cards), which are offered by pharmaceutical companies, can help patients afford the cost of specialty medications, such as drugs that treat cancer. Each program is limited to the products the company manufactures and sells. By law, these programs are only available to patients with private insurance, not those with government-sponsored insurance, such as Medicare or Medicaid
- Patient assistance programs, which are offered by most pharmaceutical companies, can help uninsured or underinsured patients afford their specialty cancer medications
- Independent foundations, such as CancerCare, the Patient Advocate Foundation, and the HealthWell Foundation, among many others, also provide financial support to patients in need. Unlike manufacturer copay programs, independent foundations may be permitted to provide assistance to patients with government-sponsored insurance as well as those with private insurance.
Many drug companies’ programs offer their cancer drugs at a greatly reduced cost, or at no cost, for patients who meet certain financial criteria. Some companies have no income requirements and provide their drugs for free to patients who meet certain eligibility criteria, such as being a US resident, having insurance, and having a prescription for their medication (for an FDA-approved indication). Many nonprofit organizations also offer financial help.
Whether patients are insured, underinsured, or uninsured, these patient assistance programs are designed to offer help with medication costs, as well as other expenses related to cancer treatment, such as travel to and from a clinic or hospital, hotel stays during treatment, or even the purchase of a wig. Becoming familiar with these options can help patients achieve the best results possible.
CONQUER: the patient voice magazine’s 3rd Annual Patient Guide to Cancer Support Services provides comprehensive listings of support services that may be available to patients. Individuals can search for assistance by their cancer type and the drugs they have been prescribed. The Patient Guide is available online, free of charge, at https://conquer-magazine.com/pssguide2019.