Patient Assistance Programs: How They Work and Who Qualifies.

Written and medically reviewed by Dorcas Morak, Pharm.D

Prescription medications can be prohibitively expensive, leaving many patients without access to the drugs they need. Patient Assistance Programs (PAPs) offer a crucial solution for those struggling to afford their medications, helping them access essential prescriptions at little or no cost. This guide explains what PAPs are, how they work, and who qualifies to benefit from them.

What are Patient Assistance Programs (PAPs)?

PAPs are initiatives—often sponsored by pharmaceutical companies, nonprofits, or state programs—designed to reduce the cost of prescription drugs for those who can't afford the medications. These programs provide medications for free or at a heavily reduced cost to eligible patients, making it easier for people to follow their treatment plans without breaking the bank.

How Do They Work?

The process for applying to PAPs can vary, but here’s a general outline of how most programs operate:

1. Application: Most programs require an application, which may include income verification, proof of no insurance coverage, and a prescription from your healthcare provider.
2. Eligibility Criteria: Programs typically target individuals with incomes below a certain threshold (based on federal poverty level) or those who are uninsured or underinsured. Applicants must also be U.S. or Puerto Rico residents.
3. Medication Delivery: Once you qualify, medications are usually delivered directly to your home, a healthcare provider, or a pharmacy for pickup.

Who Qualifies for PAPs?

To qualify for a PAP, you’re more likely to meet the criteria if:

• Your income is below a certain level: Most programs have income limits based on federal poverty guidelines.
• You don’t have prescription coverage: PAPs often prioritize people who are uninsured or whose insurance doesn’t cover the medications they need.
• You need a specific medication: Some PAPs are drug-specific, meaning they only assist patients requiring medications from the sponsoring company.

Key Tips to Qualify and Apply for a PAP

Key Tips for Applying:

1. Consult Your Doctor: Healthcare providers can help you identify available programs and guide you through the application process.
2. Gather Your Documentation: Be prepared to submit proof of income, your prescription, and sometimes medical history.
3. Use Online Resources: Pharmaceutical companies and nonprofits often offer easy-to-use online platforms to connect patients with assistance programs.
4. Be Patient: The application process can take time. Stay organized and prepared for follow-up requests.

Examples of Patient Assistance Programs

Pharmaceutical Company PAPs

Many drug manufacturers offer assistance programs. Here are a few well-known examples:

• Novo Patient Assistance Program
• Pfizer Patient Assistance Program
• Gilead Advancing Access Program
• Lilly Cares Foundation Patient Assistance Program
• GSK Patient Assistance Program
• Novartis Patient Assistance Foundation

State and Local Programs

Some states have specific programs to help residents with prescription costs.

Nonprofit Programs

Organizations like the Healthwell Foundation and the PAN Foundation offer resources and assistance with the application process.

If you don’t qualify for a Patient Assistance Program, there are still ways to save on prescription medications. The RxLess Assurance Plan offers discounts with no income or insurance requirements and no waiting period for approval. It works for all FDA-approved medications—simply download the free app to instantly access the best and most accurate pharmacy discounts in your area.