According to the new Medicare pricing, "Tier 4" medications can include the TNF-a inhibitors that have shown much promise in treating spondyloarthritis. An article in the New York Times entitled, "Co-Payments Soar for Drugs With High Prices" caused quite a stir on our message boards in regards to the new pricing schedule.

A follow-up editorial in the New York Times can be found here.

Some of our readers may also been interested in reading a blog by Dr. Adam J. Fein on the topic. His commentary can be found by clicking here.

(Editor's note: Editorial commentary on other websites does not necessarily reflect the opinion of SAA)

An article posted on the Center for Medicare Advocacy, Inc. website, has some good information regarding the Tier 4 pricing in 2008. Tier 4 includes "Specialty and Injectable drugs" and co-payments can now rise to as much as 33% the cost of the drug with co-insurance. You can read this article by clicking here.

You can contact your insurance company for information regarding possible changes in your co-payment.

Note that there are many patient assistance programs available - some from the pharmaceutical companies who manufacture the medications. Below are details on several programs:

Patient Assistance Programs

Humira

"Co-Pay Plus Card"

This Program helps with co- pay costs by covering up to $325/month of the patients' co-payment.

Once approved, the program will be in effect for a year. Patients must reapply each year to remain covered.

To be eligible for the program:

- Patient must have private health insurance, which covers the drug Humira
- Patient's co-pay must be $50 or more
- Patient cannot be enrolled in Medicare Part D
- Patient cannot be active in any government assistance plan covering Humira
- Patient cannot be a resident of Massachusetts
- There is no income cap on eligibility

Program Coverage:

- Months one through six: Program will pay up to 100% of patient co-pay, up to $325 per month.
- Months seven through twelve: Program will pay up to $325 per month, with the first $50 of co-pay paid by the patient.

For more information about this program, or to enroll, please contact Abbott Laboratories at (800)-My-Humira

Please have your physician and insurance information ready.

"Abbott Patient Assistance Foundation"

This program provides Humira at low or no cost for patients without private/public health insurance coverage, or those who have health insurance that does not cover the drug Humira. This program is need based, and income verification will be required.

Once approved, the program will be in effect for a year. Patients must reapply each year to remain covered.

For program details or to enroll, please visit the program page:
Click here

You can also contact the Foundation at (800) 222 6885, option 4.

Other Humira Programs

Abbott Patient Assistance Foundation will work with you to find other programs to assist with medication costs. Contact them at (800) 222 6885, option 4, and they will work to find a program to fit your needs.

Enbrel

"Quick Assist Card"

This Program helps with co-pay costs by covering up to $3,600/year of the patient's co-payment.

To be eligible for the program:

- Patient must have private health insurance, which covers the drug Enbrel
- Patient cannot be enrolled in Medicare Part D
- Patient cannot be active in any government assistance plan covering Enbrel

Ask your physician about enrolling in this program, or contact Enbrel's Patient Assistance Programs at (800) 282 - 7752 for more information.

"Encourage Foundation"

This program provides Enbrel at no cost to patients without private/public health insurance coverage, or those who have health insurance that does not cover the drug Enbrel. This program is need based, and income verification will be required.

Once approved, the program will be in effect for a year. Patients must reapply each year to remain covered.

For more information about this program, or to enroll, please contact the Encourage Foundation at (800) 393 - 4675.

Other Enbrel Programs

The Encourage Foundation will work with you to find other programs to assist with medication costs. Contact them at (800) 282 - 7752, and they will work to find a program to fit your needs.

Remicade

"Remistart Patient Rebate Program"

This Program helps with co- pay costs by reimbursing up to $3,200/year of the patient's co-payment.

To be eligible for the program:

- Patient must have private health insurance, which covers the drug Remicade
- Patient must be diagnosed with a condition for which treatment with Remicade is FDA approved
- Patient cannot be enrolled in Medicare Part D
- Patient cannot be active in any government assistance plan covering Remicade
- Patient cannot be receiving assistance for the drug Remicade from other foundations

For more information about this program, or to enroll, please contact the Remistart Patient Rebate Program at (877) 324 2145.

"Remicade Patient Assistance Program"

This program provides Remicade at no cost to patients without private/public health insurance coverage, or those who have health insurance that does not cover the drug Remicade. This program is need based, and income verification will be required.

Once approved, the program will be in effect for six months. Patients must reapply every six months to remain covered.

For more information about this program, or to enroll, please contact the Remicade Patient Assistance Program at (866) 489 - 5957.

Other Remicade Programs

Centocor Access One Patient Support Services will work with you to find other programs to assist with medication costs. Contact them at (800) 858 - 2585 and they will work to find a program to fit your needs.

You can also visit their website at www.centocoraccessone.com

Other Patient Assistance Programs listed in our Member Resources Directory include:

The Patient Access Network Foundation
www.patientaccessnetwork.org
(866) 316 - 7263

From their site: "The Patient Access Network Foundation is a non-profit 501(c)(3) organization dedicated to supporting the needs of patients that cannot access the treatments they need due to out-of-pocket health care costs."

Needy Meds
www.needymeds.com

From their site: "NeedyMeds is a source of information about assistance programs that help with the cost of medicine and other healthcare expenses."

RX Hope
www.rxhope.com
(877) 979 - 4673

From their site: "You can apply here for Patient Assistance Programs offered by hundreds of manufacturers, as well as find information on programs offered by State and Federal government and by pharmaceutical companies."

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