September 2nd, 2011

When Patients Can’t Afford a Medication

Editor’s Note: The following guest post by Beth Waldron is reprinted with permission from ClotConnect, a valuable resource for patients about blood clots and clotting disorders. Waldron is the program director of the UNC-Chapel Hill Blood Clot Outreach Program.

Prescription Assistance: When Patients Can’t Afford a Medication

Beth Waldron, Program Director of the Clot Connect project, writes….

Approximately 1 in 5 people don’t take a medication prescribed to them because they can’t afford to pay for it [ref 1]. While the cost of some outpatient anticoagulation therapies can be substantial, failure to take an anticoagulant medication as prescribed can have serious, even deadly, consequences.

What can a patient do when prescribed an anticoagulant that they cannot afford?

Help is available for some patients. Many pharmaceutical companies have Patient Assistance Programs (PAP) designed to help patients who cannot afford their medications obtain the medicine they need at either no or very low cost.

There is great variance among the programs offered because each pharmaceutical company establishes its own eligibility criteria for their Patient Assistance Programs along with deciding which medications are included. Most programs have some form of income guideline, require the patient complete an application form, and require a valid prescription and physician signature.

Most Patient Assistance Programs have reimbursement counselors who can answer questions about the application process over the phone.

Below is information on Prescription Assistance Programs for several commonly prescribed brand-name anticoagulants. In addition to the industry sponsored Patient Assistance Programs, several nonprofit organizations are also listed which help patients obtain discounted prescription drugs.

The following tables summarize the contact information detailed in the text. Please see the text listing for program specifics including hours of operation.

A.  Injectables – Low Molecular Weight Heparin (LMWH)





Arixtra fondaparinux sodium Injection website 1-866-728-4368
Fragmin dalteparin sodium injection website 1-866-613-4724
Innohep tinzaparin sodium injection Phone only 1-866-742-7646
Lovenox enoxaparin sodium injection website 1-888-632-8607

B.  Oral Anticoagulants





Coumadin warfarin website 1-800-444-4106
generic warfarin warfarin website 1-800-769-3880
Pradaxa dabigatran See text below for online options 1-800-556-8317
Xarelto rivaroxaban website 1-800-652-6227

C. General Prescription Access Resources




Partnership for Prescription Assistance website 1-888-477-2669
NeedyMeds website Online option only
RxAssist website Online option only

A.  Injectables – Low Molecular Weight Heparin (LMWH)

1. Arixtra® (fondaparinux sodium injection)

The manufacturer of Arixtra®, GlaxoSmithKline, offers a patient assistance program called ‘Bridges to Access’ which provides GSK medicines to eligible low income patients who do not have prescription drug benefits. Individuals who qualify for Bridges to Access receive GSK medicine at little or no cost.  Contact the program for specific eligibility requirements.

Contact Information:

Phone:  1-866-728-4368
Hours: 8AM-8PM Monday- Friday

2.  Fragmin® (dalteparin sodium injection)

The manufacturer of Fragmin®, Eisai, offers an assistance program which provides Fragmin at no cost to financially needy patients who meet program eligibility criteria. Contact the program for specific eligibility criteria. The Eisai Assistance Program can provide information to patients and healthcare professionals and can address other assistance related questions.

Contact Information:

P.O. Box 29231 
Phoenix, AZ 85038
Phone: 1-866-613-4724
Fax: 1-866-272-8805
Mon-Fri 8AM – 8PM ET

An application form is available here.

3. Innohep® (tinzaparin sodium injection)

The manufacture of Innohep®, Pharmion Corporation, has created a Patient Assistance Program (PAP). Enrollment is offered to eligible patients who do not qualify for government assistance or have third party insurance coverage and are financially unable to pay for the product. Contact the company for specific eligibility criteria and the application process.

Contact information:

Phone: 1-866-Pharmion (866-742-7646)

4.  Lovenox® (enoxaparin sodium injection)

a) For Lovenox® brand:

The manufacturer of Lovenox®, Sanofi-Aventis, sponsors a patient assistance hotline to facilitate access to their Patient Assistance Program which provides access to Lovenox in outpatient settings for under-insured or uninsured patients without the financial resources to pay for the product.

In order for a patient to be eligible for assistance, patients must be a legal U.S. resident and have an annual income at or below 250% of the Federal Poverty Line. Specific dollar amounts vary by family size and can be found on the assistance program’s website listed below.

Contact Information:

Phone: 1-888-632-8607
Fax: 1-888-875-9951
Hours: Monday-Friday, 8:00 a.m.-8:00 p.m. (EST)
On call Saturday and Sunday, 9:00 a.m.-5:00 p.m. (EST)

The application for assistance is available here.

b) For generic enoxaparin:

We are unaware of a patient assistance program for generic enoxaparin at this time.

B.  Oral Anticoagulants

1.  Coumadin®, Jantoven® (warfarin)

a)  For Coumadin® brand: 

The manufacturer of Coumadin®, Bristol-Myers-Squibb, participates in ‘Together Rx Access’ a program which offers a discount savings card good for Coumadin® brand. Card discounts range from 25-40 percent, depending upon the pharmacy   and other factors. Individuals may be eligible for the Together Rx Access Card if they do not qualify for Medicare, do not have public or private prescription drug coverage, and have a household income of up to $45,000 for a single person or $90,000 for a family of four (income eligibility is adjusted for family size). Contact the program for detailed requirements.

Contact information:

Phone: 1-800-444-4106


b)  For generic warfarin:

Generic warfarin is available through Rx Outreach, a nonprofit charitable organization that provides low-cost prescription medications to people in need across the U.S. Prescriptions are mailed directly to the patient after receipt of an Rx Outreach form, a prescription, and modest payment.

Rx Outreach is available regardless of age, use of another discount medicine program or patient assistance program. To use Rx Outreach, income needs to be less than a certain amount of money each year. This amount differs depending on the number of financially dependant people living in the house. Exact figures can be obtained by contacting the program.

Contact Information

Rx Outreach
P.O. Box 66536
St. Louis, MO 63166-6536
Phone: 1-800-769-3880

3.  Pradaxa® (dabigatran)

The manufacturer of Pradaxa®, Boehringer Ingelheim, offers a Patient Assistance Program for patients who are without prescription insurance coverage, and who meet certain household income levels. Call the program at the number below for specific eligibility criteria and information on completing the application process.

Contact Information

Boehringer Ingelheim CARES Foundation-Patient Assistance Program
Phone: 1-800- 556-8317
Hours: Monday-Friday 7:30am – 5:30pm CST

Online: The patient assistance program does not have a direct informational website, however an online application can be made at, an independent web-based patient assistance resource which processes patient assistance requests.

A print application can be found here.

4.  Xarelto® (rivaroxaban)

The Johnson & Johnson Patient Assistance Foundation provides assistance to patients who, because of financial burden and lack of prescription medication coverage, may have difficulty paying for their treatment.  Xarelto® (rivaroxaban tablets) is available to qualified individuals through the Johnson & Johnson Patient Assistance Foundation. For specific eligibility requirements, contact the program.

Contact information:

Phone: 1-800-652-6227
Monday through Friday, 9 AM TO 6 PM, ET.

An application is available here.

C. General Prescription Access Resources

There are several websites which serve as clearinghouses for information on prescription patient assistance programs and are good first stops to consult when looking for assistance, for any medication.

1.  Partnership for Prescription Assistance

The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage obtain medicines either for free or nearly free. The PPA is sponsored by a consortium of pharmaceutical research companies to offer a single point of access to more than 475 public and private programs, including nearly 200 offered by pharmaceutical companies. The program covers about 2,500 different brand-name medications and numerous generics.

Another helpful service the PPA offers is information on nearly 10,000 free community health clinics and can connect patients to one in their area. Additionally, this resource also includes connection to many regional and local based assistance programs.

PPA has both a website and a toll-free phone inquiry line. The call center accepts calls in English, Spanish and approximately 150 other languages.

Contact Information:

1-888-4PPA-NOW (1-888-477-2669)
Hours: Monday-Friday 9AM-5PM ET

2.  RxAssist

RxAssist is a web based medication assistance resource center established in 1999 with funding from The Robert Wood Johnson Foundation.  RxAssist includes a comprehensive database of patient assistance resources. RxAssist is part of the Center for Primary Care and Prevention at Memorial Hospital of Rhode Island and is sponsored by AstraZeneca.

Contact information:



3.  NeedyMeds

NeedyMeds, a non-profit information resource which helps people in need find assistance programs to help them afford their medications and costs related to health care. It offers an online index of over 570 patient assistance programs and services. Information is available in English and Spanish. NeedyMeds also includes databases on disease-based assistance, free and low-cost clinics, government assistance programs.

Contact Information:



1.  Mazer, M., Bisgaier, J., Dailey, E., Srivastava, K., McDermoth, M., Datner, E. and Rhodes, K. V. (2011), Risk for Cost-related Medication Nonadherence Among Emergency Department Patients. Academic Emergency Medicine, 18: 267–272.

Disclosure:  I have no financial disclosures relevant to this blog post.

Last updated:  August 2, 2011

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