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Foundations Offers
Free Drugs for Illnesses Common to Seniors
Oct. 28, 02 -
Several
prescription drugs that treat chronic illnesses common to older
Americans will be distributed free of charge to uninsured U.S.
residents under a new patient assistance program available nationwide.
The program is
part of an effort by the
Boehringer Ingelheim Cares Foundation, Inc. to provide
prescription medications free of charge to U.S. residents who cannot
otherwise afford them. Drugs provided under the program are commonly
prescribed to patients with acute coronary disease, stroke,
hypertension, arthritis, enlarged prostate, and chronic obstructive
pulmonary disease (COPD), as well as HIV/AIDS.
“As a maker of
life-saving drugs, we want to help patients who cannot afford their
medicines,” said Boehringer Ingelheim Cares Foundation President
Pamela S. DeMala. “We’ve developed a program to give those patients
free medication, and to get the drugs into patients’ hands quickly and
efficiently.”
Under the program,
certain Boehringer Ingelheim Pharmaceuticals’ products marketed in the
U.S. will be provided free of charge to adults and children who meet
eligibility requirements. To qualify, patients must:
·
Lack prescription
coverage under a private, government or employee insurance plan
·
Be ineligible for
prescription assistance through Medicaid
·
Have annual income
equal to or lower than 200% of the Federal Poverty Level (for 2002,
the Federal poverty level is $18,100
a year for a family of four, so the qualifying level for the Patient
Assistance Program would be $36,200 or less for a family of four)
·
For
individuals in need of the HIV/AIDS drug VIRAMUNE® (nevirapine), they
must have an annual income equal to or lower than $25,000 (for two or
more members of a family the income level would be up to $40,000).
·
Be a citizen or
legal resident of the United States
Drugs provided
include AGGRENOXâ
(dipyridamole/aspirin) Capsules, ATROVENTÒ
(ipratropium bromide) Inhalation Aerosol, COMBIVENT
â
(ipratropium bromide and albuterol sulfate) Inhalation Aerosol, FLOMAXâ
(tamsulosin) Tablets, MOBICâ
(meloxicam) Tablets, CAFCITâ(caffeine
citrate) Injection, CATAPRESÒ-TTS
(clonidine hydrochloride), MICARDISâ
(telmisartan) tablets, and VIRAMUNEâ
(nevirapine) tablets.
There will be
absolutely no co-payments or fees charged for participating in
the program, and no membership card will be required. Applicants will
not be subjected to a review of their assets.
A simple, one-page
application form is available by calling (800) 556-8317, and the
completed application must be submitted with current proof of income
and an original, valid prescription.
All applications are reviewed for
eligibility criteria and responses sent within two days of receipt.
Approved
applicants will be provided with a year’s worth of medication,
distributed in three-month supplies via the patient’s healthcare
provider. Patients are invited to reapply to extend coverage past the
initial year, and a reminder letter and application form will be sent
one month prior to the end of the initial year of participation.
Drugs available under the program include: AGGRENOXâ
(dipyridamole/aspirin) Capsules, ATROVENTÒ
(ipratropium bromide) Inhalation Aerosol, COMBIVENT
â
(ipratropium bromide and albuterol sulfate) Inhalation Aerosol, FLOMAXâ
(tamsulosin) Tablets, MOBICâ
(meloxicam) Tablets, CAFCITâ
(caffeine citrate) Injection, CATAPRESÒ-TTS
(clonidine hydrochloride) (patches?), MICARDISâ
(telmisartan) Tablets, and VIRAMUNEâ
(nevirapine) Tablets.
Patients who have
additional questions about the program can call BICF’s Patient
Assistance Program at 800-556-8317. For medical questions about the
products, health care providers can contact the Boehringer Ingelheim
Pharmaceuticals, Inc.’s Drug Information Unit at 800-542-6257
The Boehringer Ingelheim Cares Foundation, Inc. is an independent,
not-for-profit tax-exempt organization established in 2001 by the
Boehringer Ingelheim Corporation in Ridgefield, CT. The Foundation's
mission is to improve lives through innovative philanthropic
contributions and donations of healthcare products and resources.
Fact Sheet
An estimated 17 million Medicare
beneficiaries in the U.S. do not have any form of prescription drug
coverage. Many of these people have no alternatives but to either pay
for medicine out of their own pockets or go untreated.
The Boehringer Ingelheim Cares
Foundation, Inc.’s new Patient Assistance Program (PAP) will provide
many of Boehringer Ingelheim Pharmaceuticals, Inc.’s products marketed
in the United States free of
charge to individuals who do not have prescription drug
coverage and who cannot afford to pay for their prescriptions.
The Boehringer
Ingelheim Cares
Foundation’s PAP offers:
-
Up to a year’s worth of free
medicine, distributed in three-month supplies via the patient’s
healthcare provider
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Medicine available beyond one year,
upon separate request
-
No co-payments or fees
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A simple, one-page application form
Who is eligible for
the program?
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U.S. citizens or legal residents;
-
Who lack prescription drug coverage
under a private, government, or employee insurance plan;
-
Who are not eligible for
prescription drug assistance through Medicaid; and
-
Who have annual income at or below
200% of the Federal Poverty Level (see below):
|
Size of
Family Unit |
Qualifying
Income
Level for PAP -
48 Contiguous
States & DC
|
Qualifying
Income
Level for PAP -
Alaska
Residents |
Qualifying
Income
Level for PAP
-Hawaii Residents |
|
1 |
$17,720 or less |
$22,160 or less |
$20,400 or less |
|
2 |
23,880 or less |
29,860 or
less |
27,480 or
less |
|
3 |
30,040 or less |
37,560 or
less |
34,560 or
less |
|
4 |
36,200 or less |
45,260 or
less |
41,640 or
less |
|
5 |
42,360 or less |
52,960 or
less |
48,720 or
less |
|
6 |
48,520 or less |
60,660 or
less |
55,800 or
less |
|
7 |
54,680 or less |
68,360 or
less |
62,880 or
less |
|
8 |
60,840 or less |
76,060 or
less |
69,960 or
less |
NOTE:
The HIV/AIDS drug
VIRAMUNE® (nevirapine) will be made available to
individuals with an annual
income at or below $25,000 and to
families of two or more members with an annual income at or
below $40,000.
How do I
participate?
-
Request an application form by
calling 800-556-8317
(either the patient or his/her health care provider can request the
application)
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Fully complete and execute the form
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Enclose supporting documents
1.
Proof of income (Form W-2 , pay stub,
Form 1099’s, pension statements, etc.)
2.
An original prescription signed by the
health care provider (part of the application form)
Boehringer Ingelheim Cares Foundation, Inc.
Patient Assistance Program
P.O. Box 66555
St. Louis, MO 63166-6773
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All applications are
reviewed for eligibility criteria and responses sent within two days
of receipt.
How are the
medicines distributed?
-
Once the application is approved, a
three-month supply will be sent to your health care provider.
-
Before this initial supply is
finished, you or your health care provider must send in a copy of
your original application with a new prescription.
-
A refill order will then be shipped
to your health care provider
-
Patients are covered under the
program for one year, and must reapply for coverage that extends
beyond that timeframe
-
A reminder letter and new
application form will be sent to the patient or the health care
provider one month prior to the end of the initial year of
participation
What medicines are
provided through this program?
|
AGGRENOXâ
(dipyridamole/aspirin) Capsules
|
ATROVENTÒ
(ipratropium bromide)
Inhalation
Aerosol
|
COMBIVENT
â
(ipratropium
bromide and albuterol sulfate) Inhalation Aerosol |
FLOMAXâ
(tamsulosin)
Tablets |
|
MOBICâ
(meloxicam)
Tablets
|
CAFCITâ
(caffeine citrate) Injection
|
CATAPRESÒ-TTS
(clonidine hydrochloride)
|
MICARDISâ
(telmisartan)
Tablets
|
VIRAMUNEâ
(nevirapine)
Tablets
|
|
|
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Where can I get
more information?
-
Patients can call Boehringer
Ingelheim Cares Foundation’s Patient Assistance Program at
800-556-8317. Health care
providers with medical questions can contact the Boehringer
Ingelheim Pharmaceuticals, Inc. Drug Information Unit at
800-542-6257
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