Anyone with a chronic lung disease knows how important it is to take your medication as directed. But rising prices and insurance coverage changes mean some patients are struggling to fit prescribed medications into their budget. That is why the inability to afford COPD, asthma or pulmonary fibrosis, among others, is becoming a more common problem. So, what should you do if you find yourself having problems affording your medications? We have a few suggestions.
No Medication Is Not an Option
Patients with COPD or asthma will be the first to tell you that surviving without their medicine is not possible. Both airway diseases are treated with a combination of quick relief and long-acting maintenance or controller medications that are used to manage symptoms and prevent flare-ups. There are many different inhaled bronchodilators, corticosteroids or oral steroids on the market, but medications work on a case-by-case basis.
First and foremost, contact your healthcare provider and let them know if the medication they prescribed is cost-prohibitive to you. Your healthcare provider wants to help you achieve your best health outcomes, and that includes figuring out what medication you can consistently take to manage your disease. They may have ideas of substitutions or have connections to some of the additional strategies we’ll outline below.
“If you have a medication that is working for you, normally we don’t want to change that, but if you can’t afford it and there is another option that works the same way but costs less, you should consider it,” explained Mark Courtney, RRT, one of our lung health navigators at the Lung Helpline. “Consider calling your insurance company to see if there is a preferred brand they would recommend at a better price, and from there you can work with your healthcare provider to get the prescription changed.”
Mark also shared that people with pulmonary fibrosis have only two options for treatment to help slow the progression of their disease. These include nintedanib (Ofev®) and pirfenidone (Esbriet®), which are anti-fibrotic medications, meaning that they have shown in clinical trials to slow down the rate of fibrosis or scarring in the lungs. “This is one of most common calls we get because these medications are extremely expensive but also extremely necessary,” said Mark.
If you are still unable to find an affordable alternative, you may want to consider a financial assistance program.
Getting Financial Assistance
Luckily, there are many foundations out there that offer financial assistance, you just need to find them and apply. Mark suggests that people start with the PAN Foundation Fund Finder which allows you to check eligibility among 200 patient assistance funds from nine charitable organizations. If nothing is currently offered, you can sign up to be notified when something matching your criteria becomes available. “All programs set aside money based on the disease, not on a specific drug, so you might need to work with your healthcare provider to make sure that what you get through the program matches your specific needs,” Mark suggested.
Most financial assistance programs have eligibility requirements based on need and whether you have health insurance that includes drug coverage. If you don’t have health insurance or have questions about finding an affordable plan, the Lung Association has resources for you at Lung.org/openenrollment. The website Healthcare.gov has detailed information about how to get healthcare coverage you can afford.
Another option is to go through pharmaceutical companies or pharmacy chains, many of which offer access to free or low-cost medicines depending on your eligibility. Tools like SingleCare, Medicine Assistance Tool (MAT), NeedyMeds and RxAssist are free resources that offer information on a wide range of prescription assistance programs. You can get more information about these programs on our website.
For those specifically struggling with changes in inhaler prices, some drug companies offer patient assistance programs directly. For more information about medication treatment assistance visit our website.
Buyers Beware
Unfortunately, just as there are some great programs out there, there are also some scammers looking to target people looking for assistance. The biggest flag is, if the organization is reputable, it will never ask for money. This includes phone callers or even door-to-door salesmen offering discount cards in exchange for a purchase; these are not trustworthy sources. It should also be noted that drug company discounts cannot be used by people who are participating in a state or federally funded healthcare programs such as Medicare, Medicaid or Tricare.
Everyone who needs medications to manage a chronic condition needs access. If you are having trouble finding a solution, you can always contact the Lung Association HelpLine to determine if there are financial assistance programs that are right for you.
Blog last updated: June 4, 2024
