The provocative title of your article, “Lifesavers or kickbacks?”, got my attention. However, it seems misleading to suggest that patient-assistance programs are either lifesavers for patients in need of help or kickbacks to drug manufacturers, which would be a felony offense as defined in the anti-kickback statute.
The article implies that donations to independent charitable patient-assistance programs are part of drug manufacturers' efforts to keep drug prices high. The article provides no evidence of either ties between these programs and drugmakers or any effect on drug prices.
There are important differences between independent charitable patient-assistance programs operated by public foundations and those that are sponsored directly by drug manufacturers. In its “Special Advisory Bulletin on Patient Assistance Programs for Medicare Part D Enrollees,” HHS' Office of Inspector General precisely describes the important role that each type of program has in providing a safety net and the safeguards required so that lawful avenues exist for pharmaceutical manufacturers and others to help ensure that all Medicare Part D beneficiaries can afford medically necessary drugs.
It is well-known that investments in medical advances and the subsequent spending on prescription drugs can generate substantial savings and benefits by reducing or delaying the need for more expensive procedures, as well as by extending and improving the quality of life for patients with life-threatening, chronic and rare diseases.
The OIG guidance for independent charitable patient-assistance programs explicitly requires these programs, when providing help to patients with high out-of-pocket costs, to offer coverage for all drugs, both generic and brand, indicated for the treatment of a given disease or condition. This means that donations provided by Drug Company A must be used to pay for whatever drugs a patient needs regardless of whether they are made by that donating company or another manufacturer.
Rather than insinuating that drug companies are donating to independent charitable patient-assistance programs to “keep prices high and demand for their branded products strong,” the article should have called attention to the fact that many U.S. families must now spend a higher percentage of their household incomes on health insurance premiums and out-of-pocket costs than at any previous time in the past decade.
At least for now, the patient cited in your article and many other people like him who need help paying for their critical medications have nowhere else to turn to than independent public charities such as the Patient Access Network Foundation.
