September 2010 Patient Advocate News

PATIENTADVOCATENEWS Patient Advocates,

EDITOR’SNOTE

SEPOCT2010

News and information about patient assistance programs and other health care assistance

There’s a chill in the air and Halloween is just around the corner. The holiday season is not far behind. On the minds of so many Americans this month, in particular on October 12, were the 33 Chilean miners who spent 69 days trapped in the San Jose mine but who were rescued thanks to the joint efforts of individuals and groups from around the world. Companies based in Chile, the U.S., Japan, Australia, South Africa and Canada all worked together to provide supplies, equipment and support required for a successful rescue operation. Just within the U.S., companies from Kansas, Maryland and Pennsylvania—and even NASA—selflessly contributed goods and expertise for the cause. Can you imagine how successful a U.S. health care system rescue mission would be if our government and health care industries worked together the way those companies did for the miners?

Vikki Sloviter - Editor

I received an email earlier this year from Jane Cook, Program Director for PrescriptionEase, an Ohio patient advocacy group that helps residents apply for prescription assistance programs that was so passionate that I just had to interview her for this publication.

Vikki: As you mentioned in your email to me, PrescriptionEase is a service of the Mount Carmel Health System. Tell us about the history and mission of PE and how it fits in the world of assistance programs.

Jane: I was hired over six years ago to start up a new community Medications Assistance Program (MAP) for Mount Carmel Health System (MCHS), working then only part time —off a small Mount Carmel Foundation grant —to serve all four Mount Carmel hospitals in Columbus, Ohio. Now six years later, I am full time, still only completely supported financially by a Mount Carmel Foundation grant and have hired another full-time staff person two years ago, Lisa Hoffman. We specialize in identifying pharmaceutical assistance program opportunities for

prescription drugs and ensuring ongoing medication availability for our needy Mount Carmel patients.

What exactly is PrescriptionEase? Is it a medication assistance program, or an advocacy organization? What specific services does it provide, and what are its patient demographics?

I feel we are both. We are Mount Carmelʼs community medication assistance program, as well as Mount Carmelʼs “medications” advocate in our four hospital communities.

We work with other community health organizations and programs to promote the awareness of such assistance initiatives and to advocate for better medication resources (Continued on next page)

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(PrescriptionEase continued from page one)

as well as collaborative partnerships.

Specifically, we provide eligible Mount Carmel patients (low-income, non-insured) access to their name-brand prescription medications. We process all their paperwork with the drug companiesʼ Patient Assistance Programs and then we take care of their timely refills/re-enrollments once they are approved with the drug company programs.

Itʼs called PrescriptionEase because we try to make it easy for both our patients and participating doctors to use this program.

Tell us about your operating grant from Mount Carmel Foundation.

We are totally supported by one operational grant through our nonprofit Mount Carmel Foundation, and have been now for six straight years. Administrative support is provided by the Mount Carmel West hospitalʼs pharmacy department. We have no other source of funding. Annually we apply for this grant, validate our past yearʼs stats/ success and hope for our continuation/ expansion of the program. Successful program implementation, like PrescriptionEase, results in a significant return on investment in a relatively short time! The Mount Carmel Foundation is our “cheerleader”—supporting and promoting us in the community.

Iʼd really like to learn more about how PE has incorporated technology into its program. I believe you use an electronic patient charting application called ChartMaxx, and PE was involved in a pilot program for MedData. Tell us more about these and how theyʼve improved PEʼs ability to provide service to its patients.

When Lisa came on board over two years ago, she brought a wealth of experience in

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this area, on which we have capitalized! We implemented an electronic patient charting system by customizing the hospitalʼs ChartMaxx system for PrescriptionEase use, implemented electronic scanning and e-fax capabilities, and switched to a more userfriendly PAP database called MedData Services. We were fortunate to work with MedData and help “test” their new improved/ revised technological web-based PAP program before they rolled it out nationwide to their other clients. To incorporate easier processes for our doctors, nurses, and hospital staff to use us, we developed an interactive website on our hospitalsʼ intranet system. This system has provided our four hospitals and 500+ doctors access to us, at anytime from anywhere. Here, we have a downloadable, paperless referral form on this website, as well as our eligibility guidelines, contact information, expedited Plavix process information, a printable patient program handout available in three languages and much more.

Incorporating all electronic processes and having remote access to these—Lisa and I can be at any of the four hospitals, or out in the community, and have immediate access to our emails, on-line referrals coming in, electronic faxes, etc.—makes it possible for us also to work this program from anywhere and at anytime (although, at home, my husband doesnʼt always see this as a plus!).

After implementation, within the first four months, these electronic forms and processes saved us 55% in office staff time on our processes and 78% on our office supply costs, which enabled us to do more with less, by increasing our number of current active patients in the program by 15% in just the first four months!

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(PrescriptionEase continued from page two)

Another pilot program that PE has been involved in is for Bristol-Meyers Squibʼs PLAVIX medication. Explain how Mount Carmel patients have benefited from this exciting venture.

For a fourth consecutive year, the PrescriptionEase Program was granted approval by Bristol-Meyers Squibb (BMS) executives to “expedite” Plavix assistance applications for our needy heart patients.

PrescriptionEase is one of only a few advocacy programs in the United States allowed to expedite Plavix applications without initially including the required income paperwork, and have a free 90-day supply of the Plavix Fed-Exed out the next 1-2 business days to the patientʼs doctor for pick up. This service is invaluable to our cardiologists to ensure their needy heart patients have this life-sustaining medication for at least a year. The Vice President for BMS Patient Assistance Program is very compassionate and Mount Carmel is grateful for this partnership between him and the PrescriptionEase program. As of July 1st of this year, after four years, weʼve assisted over 530 patients with this Plavix service and have provided them with over $750,000 in medication retail savings.

As if you donʼt have enough to do with PE, you started the Ohio MAP Advocates Network three years ago. Tell us about that organization, and how itʼs different from PE. The Ohio MAP Advocates Network started three years ago at a national PAP convention in Baltimore, Maryland when a few Ohio advocates met and realized there are more advocates out there struggling like we were to make a difference. We decided to get together soon as an Ohio group. The “Ohio MAP Advocates Network” was then created & organized by PrescriptionEase to get together annually and “share” PAP processes, form letters, databases, measures and reports, resources, etc., to learn from each other and enhance our own

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respective programs. The second annual meeting was in October 2009 and was a showcase of PrescriptionEase/Mount Carmel Medication Assistance Programs at the Mount Carmel West campus (AM sessions) and then at The Ohio State University Medical Centerʼs MAP at OSU (for the PM sessions). The third annual meeting was hosted by the Akron General Medical Centerʼs MAP in Akron, Ohio this past spring.

In three short years, this network has grown from eight members at our start to now over 50 Ohio advocates, all working towards the common goal of providing needed medications to our vulnerable communities. I once read, and truly believe in: Coming together is a beginning. Keeping together is a process. Working together is success— TOGETHER Everyone Achieves MORE. I read on the Mt. Carmel Foundation website that several years ago all the medication assistance programs in the Mt. Carmel Health System, including PrescriptionEase, were placed under one “assistance umbrella,” directed by a Pharmacy Director at one of the participating hospitals. How did this reorganization affect PEʼs ability to provide services, what benefits or disadvantages did PE experience, and is PE still under that one umbrella?

Mount Carmel has “in-house” or hospital MAPs that serve our various low-income clinics, health stations, family practices and inpatient/outpatient IV assistance programs.

All of these initiatives continue to reduce the use of Mount Carmelʼs emergency rooms for non-emergency care due to medication noncompliance. PrescriptionEase is the “community arm” under this MAP umbrella.

We serve Mount Carmelʼs needy outpatients who have established Mount Carmel physicians. I feel Mount Carmel is ahead of the curve in this aspect, having so many successful medication assistance initiatives in place at our hospitals to serve our needy patients. We often are sought out by other (Continued on next page)

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hospitals and clinics to share our processes, procedures and success in the MAP industry.

Our Mount Carmel MAP umbrella increases community involvement in solving access to healthcare issues and prescriptions.

Some of the PE highlights that you sent me include a long list of collaborations and projects. Describe one or two specific initiatives of which youʼre particularly proud.

Besides our expedited Plavix partnership and forming the Ohio MAP Advocates Network, I recently worked on a committee for our parent organization, Trinity Health, to develop standardized reporting metrics and guidelines for current/future pharmaceutical assistance programs within the faith-based Trinity Health network (45 hospitals across the country). This effort was critical in communicating our goals, measures and data-reporting processes to Trinity leadership to ensure Mount Carmelʼs compliance in reporting PAP stats on a monthly basis to our parent organization.

Another recent community partnership formed was with the Director of the new Central Ohio Charitable Pharmacy, before their official Grand Opening in Columbus in February 2010. Our collaboration since has included us (with PrescriptionEase doctors) providing them with unopened, unexpired medications not used by our patients due to a change in meds/eligibility status, etc. In turn, they have helped us by “bridging meds” for a few of our new patients being enrolled into PrescriptionEase who desperately needed free short-term medications to hold them over until our processes could be completed for them. Awesome resource for us and the community!

If I read your email correctly, PrescriptionEase, which has only been in existence for six years and has helped more than 1,500 residents save more than four million dollars in prescription

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medication costs, has only two full-time employees. How on earth can PE accomplish so much with so few people?

What are some challenges that youʼve faced over the past six years, and how have you overcome them?

It just goes to show that even with such a small operation like ours, you can have a big impact on your vulnerable community with these programs (not to mention a huge costsavings to your health system in reduced charity costs, etc.)! Much of our success has been the result of our highly effective technological processes, which have enabled us to do much more with less time, staff and resources. But donʼt get me wrong: I am always trying to advocate for more staff and resources so that we can enroll even more needy patients! Also a huge plus for us is our unwavering support from Mount Carmel leadership and from the Mount Carmel Foundation. We have gone to them many times in the past with out-of-the-box requests and everyone has jumped through hoops to help us get to where we need to be. We are blessed here.

Finally, what plans do you have for PE, or where do you see PE five, or ten, years from now? And, how can our readers find out more about PE? I will continue to strive and keep PrescriptionEase a community-based, mission-driven program that minimizes Mount Carmelʼs uncompensated pharmaceutical costs from indigent patients and ensures our patientsʼ continuous medication therapy. Beyond the programʼs successful growth, stats and recognition, Lisa and I feel the programʼs true value is demonstrated in our patientsʼ heartfelt personal stories and touching testimonials.

This job is more than a job to us, itʼs a calling. Thanks to Mount Carmel and the Mount Carmel Foundation, we never want to lose this passion and dedication to help our needy patients gain access to their needed medications. My favorite quote sums it up best for this industry: SUCCESS—not as a finish line—but as a race in and of itself.

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HOW DO I...?

PAPTRACKER TIPS, NEWS AND UPDATES

Spend time with your patients, not with your paperwork!

Web-based PAPTracker software completes PAP applications electronically.

Enter patient and doctor information once and PAPTracker does the rest.

PAPTracker automatically creates refill reminders, too!

Qualifying nonprofit organizations may be eligible for grant support to offset software subscription fees.

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TIP: Use PAPTracker to track patient income verification dates. It’s simple. The next time you update income, enter the date in the “POI” (Proof of Income) date field and <Save>.

Then go to Reports –> Printable Report –> Patients –> POI Last Updated. Select “Dates” or “All” and then “View Report. ”Print or save as a PDF. That’s it!

NeedyMeds is pleased to announce that it has received a $100,000 grant from the Merck Company Foundation, which will be used to increase awareness of patient assistance programs to those in need. NeedyMeds will use the funds to translate its website into Spanish as well as work closely with various health care clinics to increase their knowledge of and access to patient assistance programs.

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Are you registered for our free NeedyMeds forum? This is an online community where patient advocates can share ideas and experiences, and find out the most recent PAP updates. Registration is free, but you must be a patient advocate that is employed by, or volunteers for, an organization or company that provides patient assistance (hospital, clinic, shelter, pharmaceutical company, etc.).

Click here to register today!

THERE’S AN IPHONE APP FOR THE DISCOUNT DRUG CARD! Not all needy patients are the same. While many of those that we assist may barely meet the federal poverty level and don’t know how they’re going to feed their families, others may be more comfortable but have recently lost their jobs and can’t pay for their costly prescriptions out of pocket. For the gadget-loving patients who, though they may have lost their employer-sponsored health insurance still have their iPhones, we have an app for them. NeedyMeds’ drug discount card is available as a free iTunes application. With the iTunes app, patients can show the pharmacist the app on their iPhone or iTouch (just like showing them the actual card) and receive discounts on their prescription medications. Click here to download the free NeedyMeds drug discount card app. (For a printable paper copy of our card, see the top of this page or visit our website, www.needymeds.org.) As always, the card and app are free to download and use.

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In response to reading a recent issue, Sarah Sheffield, Executive Director of NYCRx, contacted us to request being featured in an upcoming issue of this publication. Here I talk with Sarah to learn how her nonprofit partners with NYC-area clinics to implement the 340B drug discount plan.

Vikki: Tell us about the history and mission of NYCRx. How is it governed?

Sarah: In late 2005, Dr. Lynn Silver, assistant commissioner for the Bureau of Chronic Disease Prevention and Control at the New York City Department of Health and Mental Hygiene (DOHMH), received a HRSA grant to start NYCRx to address the lack of access to prescription drugs. Our mission is to provide access to low-cost pharmaceuticals to New Yorkers, especially those who are medically underserved, and to support eligible safety net providers, including Federally Qualified Health Centers (FQHCs) and Disproportionate Share Hospitals (DSHs), in maximizing the use of the Federal 340B drug discount program to reduce prescription drug costs and improve the health status of patients.

We are governed by a board of directors, which is composed of eight leaders in the New York safety-net health system. Dr. Silver is the NYC health commissionerʼs designee, and board chair, reflecting our close association to the Department of Health. Our other board members are from HHC (NYCʼs public hospital system), community clinics, local schools of pharmacy, The Heinz Family Philanthropies, and the Primary Care Development Corporation. The board meets quarterly and provides ongoing guidance as needed.

Remind us of what the federal 340B Drug Pricing Plan is and how a clinic can become a “covered entity.”

340B is a federal program that creates a ceiling price for prescription drugs for clinics that are determined to be eligible by the

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government. The ceiling price ranges from 20%-80% off retail prices, so itʼs a meaningful discount. The program has two goals: The first is simply to reduce the cost of drugs to uninsured patients. The second is to provide revenue to clinics through their commercially insured patient prescriptions.

This is a bit more complicated, but essentially, the clinic buys the discounted drugs, and a partnering pharmacy dispenses the medication and processes the claim on the clinicʼs behalf. The insurer reimburses at its “usual and customary rate” and the clinic keeps the difference.

To access the discount, the patient only needs to bring a prescription from her doctor at the clinic to one of the pharmacies with which the clinic has contracted and the pharmacist will dispense the discounted drugs. NYCRx helps the clinics to identify partnering pharmacies, establish all the needed contracts and wholesaler accounts and with training, monthly reporting and support.

As far as eligibility goes, these clinics are mainly Federally Qualified Health Centers (FQHCs) and Disproportionate Share Hospitals (DSHs), but STD clinics, clinics that receive Ryan White funding and some other similarly designated entities may also be eligible (for more details, see this site: http:// www.hrsa.gov/opa/introduction.htm). If you think your clinic might be eligible you can check the database on the Federal Office of Pharmacy Affairs website (http:// opanet.hrsa.gov/opa/CE/CEExtract.aspx).

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(NYCRx continued from page seven)

If your clinic isnʼt there, but you feel it should be, then you can fill out the form here: http:// opanet.hrsa.gov/opa/Registration/ RegistrationMain.aspx and submit it.

How does NYCRx work? How do you partner with clinics and hospitals to help them implement 340B, and what specific services do you provide them?

We generally start working with the senior staff at a clinic or hospital—either the CFO or the Medical Director—to explain the program and the benefits, and to outline the work that is involved during startup and beyond. This can sometimes involve financial analysis of prescribing patterns and the clinicʼs payor mix to ascertain potential savings and revenue from the program.

Many clinics already have informal arrangements with local pharmacies. If thatʼs the case, then we meet with those pharmacists and explain the program. If the clinic doesnʼt have a particular neighborhood pharmacy it already works with, then we conduct an RFP to see which pharmacies would like to participate and prepare the results for the clinic to review. We look at location/proximity to the clinic, proposed fees, languages spoken, hours of operation and how much natural clinic traffic the pharmacy already gets. We also work with the clinic to decide on one or more pharmacies. We then help the clinic negotiate terms, help with all contracts, wholesaler applications, and all 340B-related paperwork (including the Prime Vendor application).

When all the preparation work is done, we conduct trainings at the clinic and the pharmacy, print posters, banners, and palm cards.

NYCRx was incorporated just three years ago. What gap in services did it bridge?

There are dozens of eligible entities in the NYC area, but almost none were taking advantage of the 340B program. There are many reasons for this, but mainly these

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clinics are busy and donʼt have time to figure out the program, and they donʼt want to do something wrong. So, they do nothing.

NYCRx helps them with the whole process, from the initial paperwork to monthly reports, to annual audits.

Iʼm intrigued by the School-Based Health Center Reproductive Health Project grant.

Iʼm sure this initiative was met with some opposition and controversy given its nature. Tell us more about this project and how NYCRx is involved.

An anonymous donor gave the Department of Health a three-year grant to increase access to contraception in School Based Health Centers (SBHCs) in high schools. The DOH contacts asked NYCRx for some help figuring out the purchasing piece. When we reviewed the vendors who run the SBHCs, we noticed that all but one were eligible for 340B. So we spent the first year getting them all up and running on 340B. We reimburse them for their contraceptive purchases and track trends and savings. We just finished year two of the grant, and by helping the SBHCs purchase at 340B prices, we saved an estimated $1.2 million in the last fiscal year. Contraceptives are very deeply discounted at 340B. For example, Ortho TriCyclen Lo is about $5.95 a cycle at 340B, and about $72 on Drugstore.com.

I was surprised at the lack of controversy. But there was really no backlash. The team made sure to get buy-in from each principal.

How has the health status of New Yorkers improved since NYCRxʼs inception? What is its quantifiable impact?

While I like to think we will someday, I donʼt think NYCRx has made a population-level impact on the health status of New Yorkers.

At the clinics where weʼve launched the program, we have generated over $1 million in savings to the uninsured and over $1.6 million in revenue to the clinics. We save uninsured patients an average of $34 per (Continued on next page)

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prescription, and generate around $29 per prescription in revenue to clinics. So these are meaningful numbers, and I believe people will be more likely to take their meds if they can afford them.

How does NYCRx measure its overall success? What benchmarks did it set for itself and has it met them?

We track our success in several metrics.

Creating savings to the uninsured is central to our mission, but generating revenue for safety-net clinics is also very important to us.

Those are the key numbers that my board and I watch every month. We do also watch other factors. We monitor adherence, for example. I would like to see non-adherence go down over time, though cost is only one of many reasons people don始t take their meds as prescribed. We also watch brand/generic ratios and average cost of ingredients and feed this information back to the clinics so they can work on improving their prescribing patterns.

Over time I would hope to see a reduction in the number of New Yorkers who report not filling a prescription due to cost, which is a question in the DOH始s annual Community Health Survey. The year 2007 was the last year that question was asked, and over 10% said they did not get a needed prescription in the last 12 months (www.health.nyc.gov).

What role do technology and the Internet play in your organization, and how important do you think technology is in providing health care services?

Technology plays a huge role in what we do.

We have to manage a great deal of data each month. I cannot imagine doing our job without technology. More generally, technology holds great promise in providing health services. E-prescribing has proven a tremendous win both in terms of efficiency and in reducing medical errors.

Finally, how can our readers learn more about NYCRx? There is some general information on our website, www.nycrx.org, but if readers want more info, then they should feel free to call me at 212-676-2152 or shoot me an email at sarah.sheffield@nycrx.org.

got info?

Did you found, or do you work for, a nonprofit organization that helps people pay for medicines or provides medical assistance?

No matter how large or small your organization, we want to hear from you. Help spread the word about the impact your organization has on its community.

Email Vikki@needymeds.org if you want to be interviewed for a future issue of Patient Advocate News.

Feel free to make copies and distribute our card to your patients.

Card Front

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Card Back

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New 2010 Employer-Sponsored Benefits Survey The United States is one of the few countries in the world where health insurance status (being insured or uninsured) is so closely tied to employment status. We all know that in this country, if you lose your job, then you usually lose your health insurance (or you have to pay through the nose to extend your coverage through COBRA). Even with employersponsored insurance, employees usually have to pay part of the full premium cost, and premiums have increased much faster than inflation.

The Kaiser Family Foundation recently released its 12th annual survey that looked at employer-sponsored health insurance coverage from more than 3,000 randomly selected, non-federal public and private employers/firm with three or more workers. The survey was conducted January-May 2010. Here are some of their key findings: In 2010, the average premium for individual coverage was $5,049, and $13,770 for family coverage, a 5% increase for individuals and 3% increase for families from 2009. In the past 10 years, the average family premium has increased a whopping 114%, from $6,438 in 2000 to $13,770 this year.

Different plans have different premiums, and an employeeâ&#x20AC;&#x2122;s share of his premium differs across the board. Individuals pay a lower percentage of their total premium cost than do families, with employees paying an average of 17.8% of the total premium for single coverage, and 29% for family coverage. While HMOs typically cost employees the most (20% contribution for single coverage and 30% for family coverage), high-deductible health plans with savings option (HDHP/SO) had both the lowest single coverage contribution (14%) and the highest family contribution (39%).

Along with premiums, many employees also have a deductible. In fact, 77% of employees enrolled in a PPO (66% enrolled in a POS, and 28% enrolled in an HMO) have a deductible. In this survey, the average deductible for an employee enrolled in a PPO with single coverage was $675, $601 for an HMO plan, $1,048 for a POS plan and $1903 for a HDHP/SO plan.

Many employees also have to pay a copayment or coinsurance for office and specialty visits. Three-quarters (75%) of employees pay a copay (average of $22) while 16% pay coinsurance for primary care office visits. For specialty care visits 73% pay a copay (average $31 for in-network) while 17% pay coinsurance.

Finally, how has the recent recession affected employersâ&#x20AC;&#x2122; coverage? Thirty percent of employers said they reduced health benefits or increased cost sharing while 23% said they increased amount employee has to pay. Among large firms that employ 200 or more people, 38% responded that they increased cost sharing or reduced benefits, up from 22% in 2009.

To read the full survey, visit http://ehbs.kff.org/.

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New Disease Resource Page: HIV/AIDS As defined by the Mayo Clinic, AIDS is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight the organisms that cause disease. HIV is a sexually transmitted disease. It can also be spread by contact with infected blood, or from mother to child during pregnancy, childbirth or breast-feeding. It can take years before HIV weakens your immune system to the point that you have AIDS. Patient Assistance Programs (PAPs) are programs offered by pharmaceutical companies to help those most in need gain access to their medications at no or low cost.

NeedyMeds is pleased to announce the addition of a newly created HIV/AIDS resource page. The resource page provides information on HIV and AIDS and includes links to nonprofit patient-oriented groups that offer education, research, support and advocacy. In addition, the page lists financial resources that help with the cost of the drugs used to treat HIV and AIDS, free clinics, and programs that provide other types of financial assistance. Twenty-six patient assistance programs are listed that offer free or low-cost medications used to treat HIV and AIDS. Additionally, a link to 130 disease-based assistance programs for HIV/AIDS is included.

NeedyMeds has the most comprehensive and reliable database of patient assistance programs available. All the information is free, easy to access, and updated regularly. There is no registration process or need for users to enter any personal information. NeedyMeds is committed to serving those in need.

Faceboo As part of our outreach work, NeedyMeds is now on Facebook! Facebook is a great way to spread the word about all the help and resources available to those that need assistance paying for medications and health care costs.

The drug discount card can be printed from our Facebook Page, and our medications and patient assistance program pages can be accessed from the page, too. Even nearby free clinics can be found simply by entering a zip code!

Feel free to post your comments and experiences with NeedyMeds on our wall and share how much youʼve saved using the drug discount card, or experiences you've had using free and low-cost programs for medications. Already the word has spread and fans are posting how NeedyMedsʼ services have had a positive impact on their health.

We update our Facebook Page on a regular basis with tips, news items and other points of interest.

Feel free to join in on the discussion, ask questions and connect with other fans of NeedyMeds!

Become one of our more than 800 fans by clicking “Like” on our Page and spread the word to your friends! *Facebook is a registered trademark of Facebook, Inc. 11

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PAPUPDATES RxOutreach has removed Qualaquin from its program and has added Zerit and Demadex.

URL Pharma now has PAPs for Colcrys and Qualaquin.

Vimovo (naproxen/esomeprazole magnesium) is now covered under the AZ&ME prescription savings program.

Xubex added various doses of Atacand, Intuiv, Jalyn, Viracept, Xopenex and Zovirax to its copay and free programs.

Tribenzor is now covered by the Daiichi Sankyo Open Care Program.

Sciele Pharma is now Shionogi Pharma.

We have many updated PAP applications on our website. Keep checking to make sure you have the most current version!

For access to more PAP updates, join NeedyMeds Forums for free at forums.needymeds.com.

NEEDYMEDSSTAFF RICHARDSAGALL•MD President richsagall@needymeds.org ROBERTADOWNEY•MPA•MED Software Sales Manager roberta@needymeds.org JAYEVANDUSSEN Director of Nonprofit Outreach jaye@needymeds.org VIKKISLOVITER PAN Editor, Forums Administrator vikki@needymeds.org CHRISSYALEXANDER Office Assistant chrissy@needymeds.org CYNTHIAFOOTE Research Assistant cynthia@needymeds.org ROBINHOFFMAN Research Assistant robin@needymeds.org BILLKYROUZ Research Assistant bkyrouz@needymeds.org AMANDAMUISE Research Assistant amanda@needymeds.org SAMUELRULON-MILLER Research Assistant samuel@needymeds.org

CHECK THESE OUT! Still unsure how the new health reform law works? This Kaiser Family Foundation’s Schoolhouse Rock-esque video explains everything in nine minutes: http://healthreform.kff.org/the-animation.aspx Want to know the timeline of implementation of new health reform provisions year by year, topic by topic? Bookmark this interactive site: http://healthreform.kff.org/timeline.aspx

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WWW.NEEDYMEDS.ORG INFO@NEEDYMEDS.ORG

NeedyMeds, Inc. is a 501(c)(3) nonprofit with the mission of helping people who cannot afford medicine or health care costs. The information at NeedyMeds is available anonymously and free of charge. NeedyMeds does not discriminate on the basis of race, ethnicity, religious affiliation, gender or sexual orientation.