SPAP Information

State Pharmaceutical Assistance Programs (SPAPs)
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(Private) Pharmaceutical Assistance Programs, or Patient Assistance Programs (PAPs)

Find out whether a PAP is offered by the manufacturers of specific medications.
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‍Search manufacturers’ requirements regarding PAPs that work with Medicare coverage.
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By answering a few questions, you can screen your clients for Extra Help, SPAPs, and PAPs. Visit BenefitsCheckUp® and click on “Get Started Now” or “Find Help Paying for Prescriptions” to get started.

Through a toll-free number (1-888-4PPA-NOW) and website (www.pparx.org), the Partnership for Prescription Assistance provides a single point of access to more than 475 public and private patient assistance programs that could offer help on more than 2,500 prescription medicines.

Since some PAPs require an LIS/Extra Help denial letter before helping Medicare beneficiaries, consider advising Part D enrollees who might need PAP assistance to apply for LIS. While getting an LIS/Extra Help denial letter may create work and may delay the process, patients may qualify for LIS/Extra Help and in any event it might be the best strategy in the long run.

It might take some time for a PAP application to be processed and medicine to be sent out. Many PAP programs have medicines sent to the patient’s home or the
physician’s office, or the medicine may be available at the pharmacy. Each PAP is different.

Remember that applications generally need prescriber information and a signature.

When PAP eligibility is denied, the applicant may be able to submit an appeal. While there is no single standard appeals process, the American Society of Health Systems Pharmacists advises that: Companies may accept an appeal letter or a letter of medical necessity from the physician that accompanies the application explaining the extenuating circumstances of the financial hardship that purchasing their needed medication would cause. These are considered on a case by case basis.