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How to Get Diabetes Drugs for Free

By Jeemin Kwon, Ann Carracher, and Kelly Close 

If you meet certain income and insurance requirements, you may be eligible for assistance programs that offer free prescriptions – check to see if you qualify!

Many people know that some drug manufacturers have Patient Assistance Programs (PAPs) to make prescription diabetes drugs free for those who meet certain eligibility requirements. We’ve done a six-month-long project looking into these programs to better understand how they are similar, how they are different, and who they can and can’t help. These programs are usually reserved for individuals without private insurance or full Medicare benefits, but some programs review applications on a case-by-case basis.

Finding information about these programs can be difficult, and even when you find the information, PAPs often have complicated income, insurance, and prescription requirements. In this article, we break down current PAPs in the US by manufacturer and give the details to help you find the right program. Click to jump down to a section:

What does a PAP application look like?

Each PAP program has a similar free application, regardless of the drug that you want help with – DPP-4 inhibitors, GLP-1 agonists, SGLT-2 inhibitors, or basal or fast acting insulin, all of which are particularly expensive diabetes drugs that PAPs can help with. There is one portion to be filled out by the person who has been prescribed the drugs, and another to be completed by a doctor or nurse or one of their team. All programs require a prescription, but the applications vary in whether proof of income or particular insurance documentation is required. Here are some of our biggest learnings from our work on the ground looking at these programs:

  • Sanofi and Merck do not require proof of income for their products – among other drugs, Sanofi make Lantus and Soliqua, and Merck makes Januvia.

  • Johnson & Johnson, AstraZeneca, Takeda, Lilly, Novo Nordisk, and Boehringer-Ingelheim (BI) do require proof of income in the form of tax returns, pay stubs, or other statements – some companies may accept a note from the physician or employer confirming income.

  • Most programs have income cutoffs. Merck and Takeda have the most generous cutoffs – both at $48,240 for a single person or $98,400 for a family of four – while Sanofi has the strictest cutoff at $30,150 for a family of one or $61,500 for a family of four.

  • Most programs require that an applicant does not have private insurance and is not enrolled in Medicare, but one can still be eligible if he or she receives only Medicare Part D benefits. In particular, Takeda (manufacturer of DPP-4 inhibitor Nesina) reviews applications on a case-by-case basis.

  • In addition, if enrolled in Medicare, ruling out Low Income Subsidy (LIS) eligibility, which helps people with Medicare pay for prescription drugs, is a good practice before filling out a PAP. Click here for more information on LIS.

Not all PAPs are equal – there are factors like ease of application and less need for additional paperwork that differentiate the easy ones from the difficult ones. Keep an eye out for this “diaTribe Stamp of Approval” that acknowledges particularly helpful programs, which use the following criteria:

  • Individual income cutoff greater than $70,000 for a family of four and $35,000 for individuals

  • Application should be relatively easy to read and fill out for patients and healthcare providers

  • Additional paperwork requirements should not be too burdensome

Duration of supply if application is approved should be longer than three months 

Click here to jump down to learn more about application requirements specific to the medication you need.

Can I apply to more than one PAP?

  • Because PAPs are organized by manufacturer and not specific drugs, you can get assistance for multiple drugs from the same manufacturer without filling out multiple applications.

  • Being enrolled in one manufacturer’s PAP does not prevent you from applying to a different manufacturer’s PAP, as long as you also have a prescription for that company’s drug.

  • A general rule of thumb is that you cannot use a PAP for a drug while accepting another form of assistance or government reimbursement for the same drug.

How do I work with my healthcare provider to complete the application?

diaTribe reached out to a number of health professionals about their experiences with PAPs. While those working in private healthcare offices are sometimes less familiar with these programs, providers in community health clinics are often aware of how to use them. Unfortunately, many providers with whom we spoke found organizing the qualification requirements (like tax forms and income statements) and the additional paperwork involved in applying for PAPs to be burdensome – this isn’t too surprising given their workloads, but this was distressing nonetheless! If you believe you would qualify for a PAP, here are some strategies to get your healthcare provider help you apply:

  1. In addition to your own personal information, fill out everything you can in the rest of the application, even in the healthcare provider section, such as physician’s name, address, phone number, etc.

  2. Review the form before going to your healthcare provider’s office so you know what additional documents that the application requires – this will include proof of income (except for Merck and Sanofi’s PAPs), copies of tax forms, proof of Medicare denial, etc. In the next section of this article, you can find the requirements for each PAP.

 

Keep records of your taxes! If you don’t have a copy of your federal income tax return, click here to learn how to get one.

 

  1. Try to bring an addressed envelope with the appropriate postage. You can order postage stamps online here.

  2. Emphasize to your healthcare provider that you’ve done all that you can to fill in the forms wherever possible and their help is necessary for you to access the drugs they are prescribing, and that filling out the application would be just about ten minutes of their time!

  3. Make copies of the forms beforehand, since you might be asked to leave them behind in the office.

  4. Ask when you can follow up to make sure the provider does not have further questions of you (and to kindly make sure the forms are sent).

Patient assistance programs by therapy

Each drug manufacturer has the same assistance program for all of its drugs. If you’re not sure what company manufactures your medication, click on a diabetes drug from the list below to jump down to details about the associated assistance program.

1. AstraZeneca’s AZ&Me Prescription Savings Program

Assistance is available for:

  • Onglyza and Kombiglyze

  • Bydureon and Byetta

  • Farxiga

  • Symlin

Website: AstraZeneca’s AZ&Me Prescription Savings Program

Phone number: 1-800-292-6363

Cost: Free

Eligibility:

 

Take this easy quiz to quickly determine eligibility.

  • US citizen, permanent resident, or on a work visa

  • Must not have prescription drug coverage through private insurance or Medicare

  • If enrolled in Medicare Part D:

    • Must have spent at least 3% of household income on prescription medications since the start of the calendar year at time of application

    • Must not be eligible or enrolled in Low Income Subsidy

  • Total household income must be at or below $35,000 for a single person and $70,000 for a family of four (see this page for more guidelines)

How to apply:

  • Click here for the application, which must be completed by the applicant and healthcare provider and either mailed or faxed.

  • You will need proof of income (pay stubs, copy of Federal Income Tax Return, copy of W-2, etc.), Medicaid or Low Income Subsidy denial (if applicable), photocopy documentation of prescription medicine spending (if applicable). You can write in either your monthly or yearly income.

  • If you’ve experienced a life-changing event such as job loss, income change, loss of prescription drug coverage, marriage, or change in household number that isn’t reflected in current documentation at time of application, you are still encouraged to apply

What to expect if application is approved:

  • Application approval may last for up to a year, and AstraZenca will send an application for renewal once enrollment ends

  • Expect repeated shipments of 90-day supply for duration of enrollment (prescriber must put in the re-order request every three months)

  • For prescription refills, call 1-800-292-6363, which is open 24/7.

diaTribe’s observations about the application:

  • The application’s length is mainly due to its large, easy-to-read font – don’t let that deter you!

  • Fairly lengthy: Set aside 10-15 minutes to read and fill out the patient portion of the application.

2. Boehringer-Ingelheim Cares Foundation Patient Assistance Program

Assistance is available for:

  • Glyxambi

  • Jardiance

  • Tradjenta

Website: Boehringer-Ingelheim Cares Foundation Patient Assistance Program

Phone number: 1-800-556-8317, representatives are available Monday through Friday, 7:30 am to 5:00 pm central time

Cost: Free

Eligibility:

 

Use this online pre-screening tool to quickly determine your eligibility

How to apply:

  • Click here to access the online portal (you’ll need to create an account)

  • Click here to print out an application in English

  • Click here to print out an application in Spanish

  • You will have to submit proof of income in the form of a Federal Income Tax Return (if you haven’t filed an income tax return in the past 16 months, other forms may be accepted)

  • You will need to submit an original signed prescription from your doctor

What to expect if approved:

  • Expect repeated shipments of 90-day supply for duration of enrollment (prescriber must provide a prescription with enough refills). Refills can be requested via phone call to the customer service phone line. Reminders to refill prescriptions are also placed to enrolled participants that opt-in for phone notifications. 

  • If enrolled in Medicare Part D, benefits will end on December 31.

  • Can reapply in January.

diaTribe’s observations about the application:

  • This application requires more specific monthly income reporting than others, as it asks you to estimate “total household assets.” Check out this article explaining what household assets are.

  • Short length: Set aside 5-7 minutes to read and fill out the patient portion of the 2-page application.

3. Johnson & Johnson Patient Assistance Foundation, Inc.

Assistance is available for:

  • Invokana, Invokamet, Invokamet XR

Website: J&J Patient Assistance Foundation

Phone number: 1-800-652-6227

Cost: free

Eligibility:

 

Take this easy quiz to quickly determine eligibility

  • Must be a US or US territory resident

  • No private insurance or prescription coverage

  • If you are enrolled in Medicare Part D and need financial assistance, ask your pharmacy for a report on out-of-pocket costs for the year. Submit this report with your application

  • Household income must be at or below $36,180 for a single person and $73,800 for a family of four (see this page for more details)

How to apply:

  • Click here for the application, which must be completed by the applicant and healthcare provider and mailed or faxed

  • Submit your application with your most recent federal income tax return (1040 or 1040EZ)

What to expect if application is approved:

  • Up to one-year supply of medication

  • Can reapply annually

diaTribe’s observations about the application:

  • This application is more straightforward than others

  • Medium length: set aside 7-10 minutes to fill out this application

4. Lilly Cares Program

Assistance is available for:

  • Basaglar

  • Humalog

  • Humalog Mix 75/25, Humalog Mix 50/50

  • Humulin 70/30, Humulin N, Humulin R

  • Trulicity

  • Glucagon

Website: Lilly Cares program

Phone number: 1-800-545-6962

Cost: Free

Eligibility:

  • Must be a US citizen or resident

  • Household income under $36,180 for a single person, $73,800 for a family of four (see this page for more income requirements)

  • If eligible for Medicare Part D:

    • Must be enrolled in Medicare Part D

    • Must have spent $1,000 on prescription medicine in the current calendar year

  • If not eligible for Medicare Part D, must not have private insurance

  • Not enrolled in or eligible for Medicaid

How to apply:

  • Click here for the application, which must be filled out by the applicant and healthcare provider and be mailed or faxed

  • Must provide proof of income (pay stubs, copy of Federal Income Tax Return, copy of W-2, etc.)

  • Bring your proof of income (and other documents, if necessary) and application to your doctor, who must fill out the Health Care Practitioner section

Sign up for a text message alert to be notified that your application is approved

 

What to expect if application is approved:

  • Repeated 120-day supply for up to a year

  • Your healthcare provider can use this form to order refills

  • Can reapply every year

diaTribe’s observations about the application:

  • This is application has the most complicated eligibility requirements

  • Long length: set aside 10-15 minutes to read and fill out the patient portion of the application

5. Merck Helps  

Assistance is available for:

  • Januvia

Website: Merck Helps

Phone number: 1-800-727-5400

Cost: Free

Eligibility:

  • Check your eligibility online here

  • No private insurance or other prescription medicine coverage

  • Not eligible or enrolled in Medicare, Medicaid, and other public programs

  • Household income cannot be above $48,240 for individuals, $64,960 for couples, or $98,400 for a family of four

How to apply:

  • Click here for the application in English

  • Click here for the application in Spanish

  • No proof of income needed

  • The application should be completed by both the person with diabetes and his or her healthcare provider, and then mailed to Merck

  • Mailing address:

    • Merck Patient Assistance Program
      PO Box 690
      Horsham, PA 19044-9979

What to expect if application is approved:

  • One-year supply, shipped to either home or doctor’s office for pickup

  • You can reapply every year

diaTribe observations about the application:

  • Short length: set aside 5 minutes to read and fill out the patient portion of the application

6. Novo Nordisk’s Diabetes Care Patient Assistance Program

Assistance is available for:

  • Levemir

  • Tresiba

  • NovoLog

  • Novolin

  • Victoza

  • GlucaGen Hypo Kit

Website: Novo Nordisk’s Diabetes Care Patient Assistance Program

Phone number: 1-866-310-7549

Cost: Free

Eligibility:

  • Must be a US citizen or resident

  • No private insurance or Department of Veteran Affairs (VA) prescription benefits

  • Not eligible or enrolled in Medicaid or most parts of Medicare

    • Exception: if Medicare eligible, do not have Medicare Part D, and been denied Low Income Subsidy

    • Exception: Medicaid eligible but applied for and denied Medicaid

  • If enrolled in Medicare Part D:

    • Must have spent $1,000 on prescription medicine in the current calendar year

  • Total household income must be at or below three times the Federal Poverty Level (in 2017, 300% of the Federal Poverty Level was $36,180 for a single person and $73,800 for a family of four)

How to apply:

  • Click here for the application in English

  • Click here for the application in Spanish

  • You will need proof of income (pay stubs, copy of Federal Income Tax Return, copy of W-2, etc.), Medicaid or Low Income Subsidy denial (if applicable), photocopy documentation of prescription medicine spending (if applicable)

  • Bring your proof of income (and other documents, if necessary) and application to your doctor, who must fill out the Health Care Practitioner section

What to expect if application is approved:

  • 120-day supply, sent to prescribing health care provider’s office for pickup

  • Refills will be coordinated between Novo Nordisk and your healthcare provider

  • This program may only cover vials and not pens for new applications

To apply for Low Income Subsidy, contact the Social Security Administration at 800-772-1213 or go to www.socialsecurity.gov/prescriptionhelp/.

diaTribe observations about the application:

  • Medium length: set aside 10 minutes to read and fill out the patient portion of the application

  • Novo Nordisk will conveniently give you an automated call notifying you of your application’s status

7. Sanofi’s Patient Assistance Connection

Assistance is available for:

  • Lantus

  • Toujeo (insulin glargine U300, pen only)

  • SOLIQUA 100/33

  • Apidra

  • Admelog

  • Adlyxin/Lyxumia

Website: Sanofi’s Patient Assistance Connection

Phone number: 1-888-847-4877

Cost: Free

Eligibility:

  • Must be a US citizen or resident

  • No insurance, or existing insurance doesn’t cover Lantus

  • Not eligible for Medicaid

  • If enrolled in Medicare Part D:

    • Not eligible for Low Income Subsidy

    • Out-of-pocket drug expenses must reach 5% of annual household income

  • Annual household income cannot be higher than 250% of the Federal Poverty Level (In 2017, 250% of the Federal Poverty Level was $30,150 for single person and $61,500 for a family of four)

How to apply:

  • Click here for the application, which must be submitted by a doctor

  • No proof of income needed (income verified via soft credit inquiry)

What to expect if application is approved:

  • Expect repeated shipments of 90-day supply for duration of enrollment (prescriber must put in the re-order request every three months)

  • If enrolled in Medicare Part D, approval ends December 31st of the year in which you got approval because Medicare must be renewed every year

diaTribe observations about the application:

  • Short length: set aside 5-7 minutes to read and fill out the patient portion of the application
  • Start the application by reading page 3, which has the instructions, background, and eligibility info.

8. Takeda’s Help at Hand Program

Assistance is available for:

  • Nesina

Website: Takeda’s Help at Hand Program

Phone number: 1-800-830-9159

Cost: Free

Eligibility:

  • US citizen or resident

  • Either no insurance or not enough coverage to afford Nesina

  • Household income must be at or below four times the Federal Poverty Level, which is $48,240 for a single person and $98,400 for a family of four

How to apply:

  • Click here to print out the application, and fill it out with your healthcare provider

  • Mail application and proof of income (income tax return, Social Security benefits statement, or the past month’s income statements) to:

    • P.O. Box 5727, Louisville, Kentucky 40255-0727

diaTribe’s observations about the application:

  • Short length: set aside 5-7 minutes to read and fill out the patient portion of the application


Company investment information

Below is information provided by diabetes drug manufacturers covered in this article about the amount invested in each patient assistance program.

AstraZeneca has not yet provided any comment to our inquiry.

The Boehringer Ingelheim Cares Foundation Patient Assistance Program makes Boehringer Ingelheim medicines available free of charge to eligible patients. People can learn more about the program here. Since the Foundation was founded in 2001, it has donated over $2.2 billion in medicines through its Patient Assistance and Product Donation Programs. In 2017, the Patient Assistance Program helped approximately 50,000 patients in need through over 130,000 shipments. Diabetes medicines represent nearly 25% of the medicines dispensed.

Johnson & Johnson donates medicines and funding to the Johnson & Johnson Patient Assistance Foundation, Inc., an independent, nonprofit organization that provides Janssen medicines to U.S. patients who do not have insurance coverage for these products and do not have adequate financial resources. More information about the Johnson & Johnson Patient Assistance Foundation is available at www.jjpaf.org.

Johnson & Johnson donated medicines valued at approximately $620 million to support 2016 operations of the Johnson & Johnson Patient Assistance Foundation, enabling the Foundation to provide medicines at no cost to approximately 75,000 patients.

Eli Lilly and Company donated $685 million in free medicines in 2016 in the United States, most of which were donated to the Lilly Cares Foundation, a section 501(c)(3) organization that provides free medicines to qualifying patients.

The Lilly Cares Foundation Patient Assistance Program, a nonprofit organization, supported 111,000 patients in calendar year 2016. The largest patient populations served were mental health followed by diabetes. The Lilly Cares Foundation provided free Lilly products to 42,000 insulin-taking patients in 2016.

In 2016, Merck dispensed 1.7 million 30-day prescriptions valued at $798 million for 306,000 patients in the U.S. Patient Assistance Program.

Novo Nordisk was unable to share any information.

Sanofi: the below relates to the period of 2014 - 2016 and covers all Sanofi diabetes products that were available during this time period:

  • 378,761 diabetes patients assisted either through the PAP (free drug) program or were provided assistance with their insurance coverage

  • 596,818 diabetes PAP (free drug) orders were distributed

Takeda has not yet provided any comment to our inquiry.

Special thanks to Elizaveta Maslak and Ben Ose for contributing to this article. 

This article is part of a series on access that was made possible by support from Lilly Diabetes. The diaTribe Foundation retains strict editorial independence for all content.

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