Merck believes that donating medicines and vaccines, while not a sustainable solution to the access challenge in the United States, can provide needed assistance under certain circumstances.
To address the complex issues involved in the challenges of access to health, 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 offering includes seven programs. Through these programs, Merck has provided more than 32 million free prescriptions and vaccines, representing a total value (Wholesale Acquisition Cost) of more than $2.5 billion in the past ten years alone.
Merck Patient Assistance Program: For more than 50 years, 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.
SUPPORT™ Program: In 2007, we extended our U.S. SUPPORT Program for HIV medicines to include our new antiretroviral ISENTRESS® (raltegravir). 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® (indinavir sulfate).
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 vaccines.
Institutional Patient Assistance Program (IPAP): Merck provides medicines free of charge through bulk donations to enrolled hospitals in the United States that serve a disproportionate number of low-income, uninsured patients. The hospitals provide the product free of charge to eligible patients.
State Agency-Supported Programs: Merck also provides medicines free of charge through bulk donations to several nonprofit, state-sponsored prescription drug programs serving patients who meet eligibility criteria. Merck currently provides free medicines to state clinics in Illinois, Kentucky, Louisiana, Maryland, North Carolina, South Carolina, Texas, Virginia and West Virginia.
Effective March 1, 2009, Merck increased the income limit to the Merck Patient Assistance Program to enable more people in need to receive Merck medicines for free. Patients now may qualify for the program if their household income is $43,560 or less for individuals, $58,840 or less for couples or $89,400 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.
* The product costs associated with the ACT Program and SUPPORT are being captured under the PAP Foundation as of August, 2010.
For program details, including eligibility requirements, visit MerckHelps.com or call 1-800-50-MERCK.
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.
- Spanish education materials and applications are available.
- 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 but with extenuating circumstances can request that an exception be made.
- In 2008, in an effort to simplify patient access further, we changed the exceptions process to no longer require 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. Beginning in 2008, all toll-free phone lines for Merck medicines include an option for patients to learn about the Merck PAP. In 2009, we added PAP information 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 Web site—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.
