He says it was a choice between covering his mortgage and paying for his cancer drug.
That was the predicament facing Andre Rucker, a Baltimore heavy equipment mechanic, when he was diagnosed with multiple myeloma, a blood cancer, nearly six years ago.
Rucker's union health plan covered most of the cost of his medication, Revlimid, a maintenance therapy drug manufactured by Summit, N.J.-based Celgene with an average cost of $142,000 a year. But he still had to shell out nearly $500 a month out-of-pocket for the drug.
Then Rucker's doctor told him about the Patient Access Network Foundation, a patient-assistance program. He applied for a grant, and PAN soon was helping him cover the cost of his Revlimid, for which there is no generic alternative. “Without them, I don't think I'd be here right now,” said Rucker, 58. “I wouldn't have been able to afford it.”
Such patient-assistance programs, which often are funded largely by drugmakers, have helped many Americans like Rucker afford the medications they need. But these programs' ties to pharmaceutical companies carry a high cost for the healthcare system, critics say. It's an issue with growing resonance as drug prices continue to climb. Prescription drug spending grew 13% in 2014, compared with 5.6% growth of healthcare spending overall, according to a recent Altarum Institute report.
Critics say patient-assistance programs help manufacturers keep prices high and demand for their branded products strong, and discourage patients and doctors from switching to cheaper alternative medications. Even though some drugmakers have publicly disclosed their contributions to these programs—many of which purport to be independent charities—information about contributors remains incomplete. That makes it difficult to discern how much influence the donors have.