Patient Assistance Program

A Patient Assistance Program (PAP) is a manufacturer program that provides prescription drugs at little or no cost to patients who can't afford them. Eligibility is typically based on income (often 200 to 400 percent of the federal poverty level), insurance status (usually uninsured or underinsured), and the specific drug. PAPs are separate from copay cards — copay cards subsidize insured patients, PAPs cover the drug entirely for people who otherwise couldn't afford it.

Almost every major drug manufacturer runs a PAP for their branded drugs, and the aggregate value across the industry runs in the billions of dollars a year. Applications require income documentation and, in most cases, a prescriber attestation. Independent nonprofits like the Patient Advocate Foundation and NeedyMeds maintain searchable databases of available programs and help patients apply. Specialty drug PAPs are especially important because a single course of therapy can run $50,000 to $500,000, and losing insurance mid-treatment (through job loss, gap in coverage) would otherwise force patients off life-critical medications.

The takeaway: if a prescribed medication is unaffordable, don't skip doses — apply for the manufacturer's PAP the same day. The application takes an hour, approval usually comes within a week or two, and the drug is often free for the year with re-application options after that.