CMSA Today - Issue 8, 2012 - (Page 10)

Patient Assistance Programs Patient Assistance Programs: By Pfizer Inc. A Resource for Case Managers A s health care professionals who advocate for quality patient care, case managers see firsthand the challenges associated with access to prescription medications and medication adherence. For Americans who are uninsured and underinsured, the cost of necessary prescription medications can be a barrier to patient health and disease management. Patient assistance programs (PAPs) seek to help decrease these barriers to medications and adherence by providing eligible uninsured and underinsured populations with access to medicines for free or at a savings. For two years, CMSA and Pfizer Helpful Answers®, Pfizer’s family of patient assistance programs, have partnered to increase the CMSA community’s knowledge of patient assistance programs and to communicate how case managers can utilize these resources to help patients stay healthy. In February 2012, CMSA’s immediate past president, Mary Beth Newman, MSN, RN-BC, CCP, CCM, interviewed Pfizer Patient Assistance Foundation Executive Director, Gary Pelletier, to discuss patient assistance programs as a resource for case managers. The following section is a summary of that interview. in coverage, high co-pays or other challenges. became more engaged in managing their health after they enrolled in a Pfizer Helpful Answers program. In addition, through Pfizer Helpful Answers in 2011, more than 1 million uninsured and underinsured patients received access to more than 7.8 million Pfizer prescriptions. ROLE OF PAPS IN ADDRESSING DISPARITIES IN HEALTH CARE ACROSS VARIOUS ETHNIC MINORITY GROUPS Minority groups represent a disproportionate share of the uninsured; therefore, PAPs conduct targeted outreach to Hispanic and African American populations – the two groups with the highest uninsured rate. Programs often connect with national organizations, such as the National Black Nurses Association, National Hispanic Nurses Association and the Arthur Ashe Institute for Urban Health, to inform association chapter members about PAPs and available resources. CASE MANAGERS’ ROLE IN RAISING AWARENESS OF AND ACCESSING THESE PROGRAMS Interested individuals can visit various PAP websites for resources, tools, and ways to share information with patients. These sites often contain a section specifically designed for patient advocates like case managers to obtain more information, including training tools, material order requests, data, statistics, and details on partnerships. Because many patients do not have Internet access, advocates like case managers are essential in helping patients access PAPs. On PAP Web sites, case managers and their patients will find forms with a few brief questions to determine patient qualification. For various reasons, patients can have trouble filling out PAP forms. Case managers can facilitate this process by helping patients with PAP forms and informing them about available resources. Useful sites to access additional information include the Partnership for Prescription Assistance (,, and, which can connect patients to resources that may help them get access to their prescription medicines. ©2012 Pfizer Inc. ■ POPULATIONS SERVED BY PATIENT ASSISTANCE PROGRAMS Patient assistance programs serve two main populations: uninsured and underinsured individuals. For the purpose of these programs, uninsured is defined as someone who does not have prescription coverage, while underinsured is defined as a patient who has some prescription coverage, but not enough for their needs. While PAPs most commonly serve the uninsured population, they can also assist individuals with prescription coverage, such as Medicare or commercial insurance, who are having difficulty paying for their medicines due to gaps 10 CMSA TODAY DEMONSTRATED OUTCOMES OF PARTICIPATION IN MEDICATION ASSISTANCE PROGRAMS Many patient assistance programs track and monitor patients’ experience with the programs. For Pfizer’s programs, this information is gathered every two years by conducting a survey of patients who have participated in Pfizer Helpful Answers. The most recent survey, completed in 2011, found that patients felt more positive about their health and Issue 8 • 2012 • DIGITAL

Table of Contents for the Digital Edition of CMSA Today - Issue 8, 2012

President's Letter
Transitions in Care
Passion in Case Management
Patient Assistance Programs
Association news
View from Capital Hill
Case Management and the Law
Ethics Casebook
Mentoring Matters
CMSA Corporate Partners
Index of Advertisers

CMSA Today - Issue 8, 2012