At Merck, we believe that no one should go without the medicines or vaccines they need.
That is why the company provides its medicines and adult vaccines for free to people who do not have prescription drug or health insurance coverage and who, without our assistance, cannot afford their Merck medicine and vaccines. This is consistent with Merck’s long-held values and tradition of putting patients first.
More than 55 years ago, Merck created our first U.S. Patient Assistance Programs (PAPs) to keep affordable medicines within patients’ reach. Today, our patient assistance offerings include several programs. Through these programs, Merck has provided more than 34 million free prescriptions and vaccines, representing a total value (wholesale acquisition cost) of more than $3.2 billion in the past 11 years alone.
Merck Patient Assistance Program: The Merck Patient Assistance Program has provided Merck medicines free of charge to millions of eligible individuals who, without our assistance, could not otherwise have afforded them. A single application may provide for up to one year of medicine free of charge, and an individual may reapply as many times as needed. Under certain circumstances, individuals who don’t meet the prescription drug coverage criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial and medical hardship, and their income meets the program criteria.
Eligibility for Merck Programs
If you have been prescribed a Merck medicine, you may be eligible for the program if all three of the following conditions apply:
1. You are a U.S. resident and have a prescription for a Merck medicine from a doctor licensed in the United States.1
2. You do not have insurance or other coverage for your prescription medicine. Examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy-assistance programs, veteran’s assistance, and any other social-service-agency support.
3. You cannot afford to pay for your medicine. You may qualify for the program if you have a household income of $46,680 or less for individuals, $62,920 or less for couples, or $95,400 or less for a family of four.2
More information about this program is available at MerckHelps.com.
Merck Vaccine Patient Assistance Program: Launched in 2006, the Merck Vaccine Patient Assistance Program is a private and confidential program that provides Merck’s adult vaccines free of charge to uninsured adults age 19 or older who cannot afford their medicines.
Merck Bulk Replacement Patient Assistance Program: The Merck Patient Assistance Program, Inc., may be able to provide medicines and adult vaccines free of charge through periodic bulk replenishments to eligible facilities that serve a large percentage of low-income, uninsured patients. Types of eligible facilities include outpatient pharmacies of disproportionate-share hospitals and nonprofit healthcare clinics that have a licensed outpatient central-fill pharmacy that is owned and operated by the facility. The eligible facilities, under an agreement with the Merck Patient Assistance Program, Inc., review the eligibility of patients for assistance under the program’s criteria, with replenishment being limited to patients meeting specified income and insurance criteria.
SUPPORT™ Program: To ease the healthcare reimbursement process, Merck has created the SUPPORT™ Program to help patients who have been prescribed ISENTRESS® (raltegravir) 400 mg Film-Coated and 25 mg and 100 mg Chewable Tablets, and CRIXIVAN® (indinavir sulfate) 200 mg and 400 mg Capsules. The SUPPORT Program provides both personalized reimbursement support that helps patients navigate what can be a complex insurance and reimbursement system, and assistance with prior authorization, identifying insurance options, and reimbursement. The program also provides medicine free of charge to eligible patients lacking coverage for ISENTRESS and CRIXIVAN.
ACT Program: The ACT Program is designed specifically to assist patients with insurance reimbursement issues and questions, and to provide product free of charge to those eligible individuals lacking coverage for Merck’s oncology and hepatitis C medicines.
Merck Hotline Program: The Merck Patient Assistance Program for INVANZ® (ertapenem for injection), PRIMAXIN® (imipenem and cilastatin for injectable suspension), and CANCIDAS® (caspofungin acetate) for Injection is a program designed to help indigent and uninsured patients. This program provides reimbursement support and patient assistance/product replacement to healthcare facilities.
Most of Merck’s PAPs also continue to be available to Medicare beneficiaries who are not enrolled in a Medicare drug plan, as well as Medicare beneficiaries who enroll in a Medicare drug plan but still cannot afford their Merck medication. Such individuals have to attest that they have special circumstances of financial and medical hardship and that their income meets the program criteria.
For Patient Assistance Program details, including eligibility requirements, visit MerckHelps.com or call 1-800-PAP-5400 (1-800-727-5400).
Designed for Ease of Use
In recent years, we redesigned the Merck Patient Assistance Program with the goal of simplifying and streamlining the patient assistance process for both healthcare providers and patients. As a result:
- A simple one-page, two-sided form was created
- Only a completed application signed by both the patient and the prescriber is required
- Education materials and applications are available in Spanish
- Patients can receive a 90-day supply of Merck medicines with up to three refills—for a total of up to one year of medication
- Up to three scripts per application can be submitted
- Medicines can be mailed directly to a patient’s home or to a prescriber’s office
- Under special circumstances, patients with insurance who have extenuating circumstances can request that an exception be made
- In an effort to simplify patient access further, the exceptions process no longer requires a prescriber’s signature to the “exceptions request” authorization form, although a prescriber’s signature is still required on the initial PAP application
Communicating Our Programs to Doctors and Consumers
Merck is also working to raise awareness of our PAPs to doctors and eligible patients via brochures about and applications for the Merck Patient Assistance Programs distributed by our sales representatives to physician offices and clinics nationwide. All toll-free phone lines for Merck medicines include an option for patients to learn about the Merck PAPs. Also, PAP information is added to all new Merck direct-to-consumer advertisements, including a phone number for more information.
Partnership for Prescription Assistance
Merck also participates in the pharmaceutical industry initiative Partnership for Prescription Assistance (PPA). The Partnership brings together America’s pharmaceutical companies, as well as doctors, patient advocacy organizations and civic groups, to help low-income, uninsured patients get free or nearly free brand-name medicines. PPA does this by offering one place—a single website—that provides information and access to more than 475 public and private patient assistance programs, including more than 200 programs offered by pharmaceutical companies like Merck. To date, PPA has helped millions of Americans get free or reduced-cost prescription medicines.
Merck’s participation in PPA underscores the company’s commitment to helping the uninsured gain access to Merck medicines. To learn more about the Partnership for Prescription Access, visit www.pparx.org.
1 You do not have to be a U.S. citizen. If you do not meet the prescription drug coverage criteria, but your income meets the program criteria and there are special circumstances of financial and medical hardship that apply to your situation, you can request that an exception be made for you.
2 For income limits in Alaska, Hawaii, Puerto Rico, U.S. Virgin Islands and Guam, please call 1-800-727-5400.
The main driver of the decrease in patient and prescription volumes for 2013 is the periodic changes in the products covered by the various patient assistance programs. These changes are due, in part, to company divestitures, the introduction of competing products, and the availability of generic alternatives.
Last Updated October 22, 2014