Merck believes that donating medicines and vaccines, while not a sustainable solution to the challenge of patient access to healthcare in the United States, can provide needed assistance under certain circumstances.
To address the complex issues involved in the challenges of access to healthcare, Merck is working with government and private sector partners to help find long-term policy approaches that make health coverage available to the people who need it. In the meantime, Merck has created several programs to help address this challenge.
More than 50 years ago, Merck created our first U.S. Patient Assistance Program to keep affordable medicines within patients’ reach. Today, our patient assistance offerings include seven programs. Through these programs, Merck has provided more than 33 million free prescriptions and vaccines, representing a total value (wholesale acquisition cost) of more than $2.67 billion in the past ten 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 afford 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. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy-assistance programs, veteran’s assistance, or 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 $45,960 or less for individuals, $62,040 or less for couples, or $94,200 or less for a family of four.2
More information is available at MerckHelps.com.
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) 100 mg, 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 provides 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 specifically designed to assist patients with insurance reimbursement issues and questions, and to provide product free of charge for those eligible individuals lacking coverage for Merck’s oncology and hepatitis C medicines.
Merck Hotline for INVANZ®, PRIMAXIN® and CANCIDAS®: The Merck Hotline for INVANZ (ertapenem sodium), PRIMAXIN (imipenem and cilastatin) and CANCIDAS (caspofungin acetate) program provides reimbursement support and patient assistance/product replacement to healthcare facilities.
Merck Vaccine Patient Assistance Program: Launched in 2006, the Merck Vaccine Patient Assistance Program offers 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.
Effective February 1, 2013, patients may qualify for the program if their household income is $45,960 or less for individuals, $62,040 or less for couples, or $94,200 or less for a family of four.
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 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
- To request enrollment, 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
- We provide the option of mailing medicines 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 PAP to doctors and eligible patients via brochures about and applications for the Merck Patient Assistance Program 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 PAP. 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, the PPA has helped more than 6.8 million patients.
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.
Last Updated July 29, 2013