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“We see patients who can’t take the full dose. They cut their pills in half. They skip doses. People with diabetes who don’t take the required amount of insulin to manage their Type 1 diabetes let their blood sugars spike dangerously before they take an injection, because they can’t afford it. People with rheumatoid arthritis who have terrible pain because they can’t take the full dose required to manage that disease. People are angry, and they’re hurting, and they don’t understand how this could be happening to them in the United States of America.”
One reason, he says, is the fact that drug companies that develop new drugs are given the exclusive right to sell them for a period of years.
“The idea is you made an investment. You deserve a return on that investment. For a small molecule drug, a period of exclusivity is five years. For an orphan drug for a small population, the period of exclusivity is seven years. For biologics it’s 12 years. During that period of exclusivity, you are able to exercise monopoly pricing power. The short outcome of that is that drug companies are able pretty much to charge whatever they want, and we have no way to stop them.”
Former Congressman Henry Waxman, who cosponsored the 1984 Hatch–Waxman Act that reformed the system for drug approval and patenting, offers a related explanation. He says companies defend high prices by claiming they need money for research and development.
“PHRMA, the trade association for the pharmaceutical industry, is quite powerful. They’ve increased their lobbying budget. They’ve increased their advertising budget. They have a sympathetic case to make when they suggest to people who are suffering from diseases for which there are no cures that there may not be cures if their incentives are taken away.”
There are over 270 Patient Assistance Programs. Each Patient Assistance Program has different qualification guidelines. However if you meet the following three conditions you will more than likely qualify for these programs.
The exact definition of economic hardship varies with each Patient Assistance Program. Most Prescription Assistance Programs adhere to a formula related to the Federal Poverty guidelines. If your income is 400% below the Federal Poverty guidelines, then you will most likely qualify. The qualifying income levels for the most current year are outlined below.