MEDICATION HELP

• If you have a condition that requires expensive medication, there may be help for you. Many drug manufacturers have patient assistance programs that allow people who meet certain criteria to get costly medications for free. Most programs have generous cutoffs, with families earning less than 400% of the federal poverty level eligible (in 2022, 400% of the federal poverty level is $54,360 for 1 person and $111,000 for a family of 4).
• The tables below list expensive medications that have patient assistance programs. Medications are grouped by the condition they treat, and links to program information and applications are provided. Drugs that only ship to the doctor are not practical for telemedicine. Fortunately, every drug class contains a medication that ships to the patient or pharmacy, so therapy can be changed to one of these medications if necessary.
• If you are interested in a particular drug or condition and do not see it below, feel free to email us about it

• Asthma
• Atopic dermatitis / Eczema
• Atrial fibrillation
• COPD
• Crohn's disease
• Deep vein thrombosis (DVT)
• Diabetes
• Insulin
• SGLT2 inhibitors
• GLP-1 analogs
• DPP-4 inhibitors
• High cholesterol
• HIV pre-exposure prophylaxis (PrEP)
• Hepatitis C
• Migraine headache
• Pulmonary embolism (PE)
• Psoriasis and psoriatic arthritis

Asthma inhalers

• The three classes of inhaled asthma medications are beta agonists, corticosteroids, and antimuscarinics. Asthma inhalers contain one or a combination of these medications.
• The table below contains PAP information for all the available asthma inhalers

Atopic dermatitis / Eczema

• Atopic dermatitis (also called eczema) is a chronic skin condition marked by recurrent outbreaks of irritated, itchy patches of skin. It has traditionally been managed with topical steroids, but in recent years, a number of medications, including biologics and newer immunosuppressants, have been approved for its treatment. PAP information for these expensive medications is provided in the table below.

Atrial fibrillation

• Atrial fibrillation is a heart arrhythmia that increases a person's risk of stroke. Most patients with atrial fibrillation take anticoagulants for stroke prevention.
• There are 5 anticoagulants that can be used in atrial fibrillation. Four of them are newer medications that do not require frequent lab monitoring, but they have no generics and are expensive. Warfarin is an older anticoagulant that is cheap and effective, but it sometimes requires frequent lab monitoring (PT/INR), especially upon initiation. The table below gives the PAP information for the 4 newer drugs.

COPD inhalers

• The three classes of inhaled COPD medications are beta agonists, corticosteroids, and antimuscarinics. Asthma inhalers contain one or a combination of these medications.
• The table below contains PAP information for all the available COPD inhalers

Crohn's disease

• Six biologics are approved to treat Crohn's disease: Adalimumab (Humira®), Certolizumab (Cimzia®), Infliximab (Remicade®), Ustekinumab (Stelara®), Vedolizumab (Entyvio®), and Natalizumab (Tysabri®). I can help patients obtain Humira®, Cimzia®, and Stelara® (see PAP info below). The other 3 medications are given by IV infusion at a doctor's office.
• Other treatments like azathioprine, mercaptopurine, and methotrexate have cheap generics

Deep vein thrombosis (DVT)

• Deep vein thrombosis is a condition where a blood clot forms in the deep vein of the legs. DVTs can lead to pulmonary embolisms so patients must be anticoagulated for treatment and prevention.
• There are 5 anticoagulants that can be used for DVTs. Four of them are newer medications that do not require frequent lab monitoring, but they have no generics and are expensive. Warfarin is an older anticoagulant that is cheap and effective, but it sometimes requires frequent lab monitoring (PT/INR), especially upon initiation. The table below gives the PAP information for the 4 newer drugs.

Diabetes - insulin

• There are 3 manufacturers who make insulin - Sanofi, Novo Nordisk, and Lilly. Each manufacturer has a program for free insulin through a patient assistance program (PAP). The Lilly program will ship the insulin to the patient's home and the other two only ship the insulin to the doctor's office. With telemedicine, only the Lilly program is practical.
• Sanofi and Novo Nordisk also have $99/month insulin programs where patients can get any combination of the insulin products they manufacture for a flat $99/month. The Sanofi program allows for up to 10 products (vials and/or packages of pens) per month and the Novo Nordisk program only allows for up to 3 products. In April 2020, Lilly launched a program in response to the COVID-19 pandemic that offers monthly supplies of Lilly insulins for a flat $35 copay. The program is for patients both with and without commercial insurance.
• Links to details on all of the programs are provided in the table below. All 3 manufacturers offer a basal and premeal insulin, so no matter what insulin product(s) you use, your insulin(s) can easily be switched to comparable products from another manufacturer. See the StraightHealthcare insulin chart for a list of insulins grouped by type. Also, Novolin NPH and Novolin R are sold at Walmart for $25 a vial, and any insulin regimen can be switched to these 2 products.

Diabetes - SGLT2 inhibitors

• The ADA now recommends SGLT2 inhibitors as second-line therapy after metformin in diabetics who have cardiovascular disease, heart failure, and/or chronic kidney disease. No SGLT2 inhibitor has a generic, and they are expensive.
• Links to patient assistance programs for the four SGLT2 inhibitors that are currently available are in the table below. All the drugs with PAP programs will ship to a pharmacy or the patient's home.

Diabetes - GLP-1 analogs

• The ADA now recommends GLP-1 analogs as second-line therapy after metformin in diabetics who have cardiovascular disease. No GLP-1 analog has a generic, and they are expensive.
• Links to patient assistance programs for all GLP-1 analogs are listed below.

Diabetes - DPP-4 inhibitors

• DPP-4 inhibitors are a class of drugs used to treat type 2 diabetes. Alogliptin is the only DPP-4 inhibitor that has a generic.
• Links to patient assistance programs for all DPP-4 inhibitors are listed below.

High cholesterol

• High cholesterol is typically treated with a class of drugs called statins which has many cheap generics. A new class of highly effective injectable drugs called PCSK9 inhibitors has also become available. There are two drugs in the class and they are very expensive. PAP information for the two drugs is provided below.

HIV pre-exposure prophylaxis (PrEP)

• Two drugs are approved for HIV PrEP therapy - Truvada® and Descovy®. Both are made by Gilead and they fall under the same PAP.

Hepatitis C

• There are currently 6 medications available to treat hepatitis C. Treatment recommendations vary by hepatitis C genotype, degree of liver disease, and previous treatment. See hepatitis C treatment for more.
• The table below contains PAP information for the 6 hepatitis C medications

Migraine headache

• Medications approved to treat migraine headaches have expanded recently. Older drugs (e.g. triptans) typically have cheaper generics, but the newer drugs do not.
• The table below lists the PAP information for some of the newer therapies and a few of the older ones

Pulmonary embolism (PE)

• Pulmonary embolism is a condition where a blood clot in the venous system travels through the circulation and lodges in the lung tissue. Pulmonary embolisms can be life-threatening so patients must be anticoagulated for treatment and prevention.
• There are 5 anticoagulants that can be used for PEs. Four of them are newer medications that do not require frequent lab monitoring, but they have no generics and are expensive. Warfarin is an older anticoagulant that is cheap and effective, but it sometimes requires frequent lab monitoring (PT/INR), especially upon initiation. The table below gives the PAP information for the 4 newer drugs.

Psoriasis and Psoriatic arthritis

• A number of biologic medications are now approved to treat psoriasis and psoriatic arthritis. The tables below contain PAP information for these medications. Information for apremilast (Otezla®), a nonbiologic systemic therapy, is also provided.