What are PAPs?

Prescription Assistance Programs, or PAPs, have emerged in an effort to help patients who lack health insurance/ facility or prescription drug coverage obtain the medications they need. These programs are typically offered to provide free or low-cost prescription drugs to qualifying individuals.

By providing financial assistance for hundreds of medications, PAPs provide a valuable resource to patients, helping them comply with recommended drug regimens and, in turn, obtain better health outcomes.

Millions of Indians could not get the medicines they need and most of them even can’t afford. PAPs are also called patient assistance programs or medication assistance programs.

Eligibility and Enrollment Requirements

It is important for healthcare providers, patients and caregivers to research and understand the eligibility criteria and application process for specific PAPs as they differ considerably from one program to the next.

In general, most programs require the applicant have:

  1. Limited or no prescription drug coverage from private or public sources;
  2. A demonstrated financial need based on set income and asset limitations; and,
  3. Proof of residence.

Steps in the Process

Although there is no standard enrollment process, most PAPs require the health care provider, patient, or both to complete an application form. A doctor’s signature is almost always required. A single form applicable to all of their medications while in some cases may require separate form for each drug. Forms are available online (See list of Resources to get help).

The type and depth of information requested also varies. The program application may require information about the patient’s:

  • Diagnosis and medical need which would need to be documented by the treating physician, pharmacist, nurse, or patient advocate;
  • Health and drug insurance coverage to show that the patient does not have prescription drug coverage and/or does not qualify for private or public health insurance. In many cases, patients who have health insurance but do not have prescription coverage are eligible for PAPs.
  • Individual or household income documented bank statements or financial status by responsible neighborhood person. In most cases, a person’s income needs to fall below 200% of the Federal Poverty Level (FPL).

200% FPL for 2017

Family Size Gross Annual Income
1- ₹ 24,600
2- ₹ 32,400
3- ₹ 40,200
4- ₹ 47,500
  • Source: Department of Health and Human Services

If approved, the patient’s prescription is generally sent to the Oriental pharmacy for distribution. The patient typically receives a 30– to 90-day supply. The PAPs require the patient to submit a new application in order to receive a refill of their prescription.

PAPs are constantly changing as new medications are added or removed and enrollment requirements are modified.