Have you ever stood at the pharmacy counter, minding your own business, when the pharmacist announces the price of your prescription… and you briefly leave your body?
“Your total is $958.00,” they say cheerfully, as if they’re telling you the weather forecast.
I know. I’ve been behind that counter, but it was way different in the 1990’s. Back in the day, I had to deliver that kind of news (although I gave more warnings before dropping the bomb). I used to watch customers turn pale, swear, cry, or look around for a hidden camera. I’ve been yelled at as if I was the one setting those stupid prices.
So let me be your hero today and tell you something people don’t know: There are Patient Assistance Programs (PAPs) that will reduce the cost of brand-name medications dramatically! Sometimes by 50 and sometimes even up to 95%. Once in a while, it’s free!
Patient Assistance Programs aren’t new. They’ve actually been around since the 1990s, but they looked very different back then, that’s why it was so awful for customers (and retail pharmacists like me that had to deliver the news).
Back in the Old Days – Patient Assistance Programs (PAPs) Were Horrid!
You see, in the early days, these programs were primarily intended for people with absolutely no insurance or those with extremely low income, and the process was slow and cumbersome.
Applications had to be filled out on paper with a pen! Then they had to get snail-mailed or faxed in. It was so archaic! And to make it worse, approvals could take weeks if they even got back to you! I bet some of you reading this remember all that trauma. Hardly anyone knew a PAP existed because there was no easy way to search for them (Google wasn’t around), and plus, only a small handful of medications even offered assistance!
In other words, Patient Assistant Programs were once quiet, charitable hardship programs, nothing like the fast, user-friendly savings tools we have today.
So right now I’ll share the latest on PAPs because it can save you thousands of dollars. Just so you know another pro-tip, there are ways to take two different dirt-cheap medicines (instead of one pricy new-fangled one) which will also save thousands of your hard-earned dollars! Keep that in mind. I’ll explain more about that at the end of this blog. First things first, this blog is primarily about Patient Assistance Programs because that’s where you can save BIG – and instantly.
New and Current PAPs Save You Tons of Money
Let me give you a real-life example.
My yoga friend’s husband was recently prescribed Xifaxan, a medication used to treat certain gastrointestinal infections. When she told me of his long-standing symptoms, I immediately suspected they were due to an opportunistic gut pathogen, so I recommended he take a stool test called the GI-MAP.
Sure enough, the results revealed elevated levels of Proteus mirabalus, Citrobacter freundii, and Streptococcus spp, and a few others finally explaining years of abdominal misery. (You can get it from my Lab Shop if you want to take this test or see a Sample Report of what it tests for).
His doctor reviewed the findings and prescribed two antibiotics: Metronidazole and Xifaxan. The metronidazole is dirt cheap, so no problem there. Xifaxan on the other hand has a jaw-dropping price!
So when they went to fill the prescription, the pharmacy charges $2,448.00. Yes… two thousand five hundred dollars! For just one medication – a 2 week supply.
The pharmacy called them and asked that dreaded question:
“Do you still want it?”
Because what else can you do? Stay sick?
Well… here’s where I swooped in wearing an invisible cape, lol.
She texted me and told me the price and asked if it was really needed. I said, “YES, but don’t pay that, it’s crazy!!! Give me a minute”
Step 1: I looked up the manufacturer’s Patient Assistance Program (PAP)
I looked for a PAP. This took 10 seconds to search on Google. I couldn’t remember the manufacturer’s name off the top of my head, but you don’t need that information, it comes up on the search. (For Xifaxin, the maker is Salix.)
Many brand-name manufacturers have a savings program nowadays. And all you have to do is look! You can Google it, and if a PAP exists for your medicine, you have to qualify. That sounds harder than it is. To “qualify” you have to simply enter a few basics, and if approved, they generate a coupon instantly.
I texted her the link and said “Have him fill this out real quick.”
Once they had the link, they filled out the patient’s required information (name, email, insurance info if you have any) and a couple other questions. In less than a minute her husband was qualified. The website issued the necessary discount “card” with specific numbers on it which then discounted his medication dramatically.
Step 2: She called the pharmacist back and read the magical numbers off his card.
Once you qualify for a patient assistance program (and it’s immediate usually), the coupon gives you the discount codes. You’ll see these numbers somewhere on the card:
- A BIN
- A PCN
- A Group
- And an ID number
These literally ‘tell’ the pharmacy’s computer: “Hey, apply the manufacturer savings. Don’t charge this poor soul full retail for God’s sakes!”
Step 3: Boom — the cost dropped from ~$2,448.00 to about $759.00
That’s roughly a 70% savings captured in under five minutes.
Tell me that’s not sorcery?! I was exhilarated and felt like I had hit the lottery! My friend was too – she was so grateful she insisted on taking me out for sushi, so we called it even.
Discounts Happen!
As another real-life example, there was a time when a doctor prescribed my husband some Pennsaid Gel. It’s basically like ibuprofen for the skin… except not really, because it’s technically a different NSAID called diclofenac, but you get the idea. A rub-on anti-inflammatory gel. This was useful after his partial knee replacement.
And here’s where it gets interesting: Pennsaid is essentially just another brand of Voltaren Gel, which you can buy over the counter at literally any pharmacy. (Side note in my humble opinion, the OTC diclofenac gel (ie Voltaren) works just as well without the drama, hoops, or sticker shock.)
Anyway, to the point… this fancy Pennsaid gel prescribed rang up at a jaw-dropping $1,500. For one bottle.
I thought that was ridiculous, that bottle better dispense diamonds! So I found a PAP (patient assistance program) for it because the doctor (for whatever reason) insisted he use that specific brand. Sure enough, there was one. Sam filled out the online form, and in about two minutes he was approved to get it for… nothing. Literally free. Which, by the way, is even cheaper than a tube of Voltaren Gel, so of course we went for it.
The bigger message here is this: A lot of specialty or brand-name drugs have Patient Assistance Programs, and they don’t care if you have a good income, or great insurance, or whatever. They’re out there — you just have to take a minute to look. Discounts happen!
Do Doctors Get Kickbacks?
If you’re doctor sends you home with a card offering a PAP, or tells you to get a PAP, you can be assured they are NOT getting kickbacks. They’re just trying to help. So if you’re wondering, doctors do not get kickbacks, commissions, bonuses, referral fees, or any financial incentive when they send the patient to a Patient Assistance Program. That would be illegal under multiple federal laws.
Why they can’t get paid for it
- PAPs are funded and administered by the drug manufacturers
- Federal law prohibits any arrangement that induces prescribing. CLICK HERE for the anti-kickback laws if you’re curious.
- Even mentioning a PAP to a needy patient cannot be tied to physician compensation.
- There’s no tracking or referral system, the doctor won’t even know if you used the PAP unless you tell them you got a good deal on the drug they prescribed.
What Exactly Is a Patient Assistance Program?
It’s a financial support program offered by drug manufacturers to help patients afford expensive brand-name medications. They’re especially helpful and usually available for these four circumstances:
- There’s no generic alternative (like Xifaxan)
- Your insurance puts the drug in a high-tier copay bucket
- You have a high deductible plan
- The cash price is ridiculous (as in most specialty meds)
Most PAPs fall into two categories which are the savings cards, and the full/complete assistance cards – let me go over those next:
1. Savings Cards / Copay Cards
If you have commercial insurance (like Aetna, Anthem, BCBS, UHC, Cigna, etc.), many drug manufacturers offer copay or savings cards that can dramatically reduce your out-of-pocket costs—sometimes down to zero. This is especially helpful for expensive medications like Xifaxan, which I mentioned earlier.
Important: Copay and savings cards do NOT work with Medicare, Medicaid, Tricare, VA, or any other government-funded insurance plan.
That’s not the drug company being stingy—it’s due to federal law. Manufacturers are legally prohibited from offering these types of discounts to patients on government programs.
But here’s the good news: if you’re on Medicare or Medicaid, you’re not out of luck. Many pharmaceutical companies run Patient Assistance Programs (PAPs) through separate nonprofit foundations. These may provide your medication at low cost or even for free, depending on your income level. You’ll usually need to submit a short application, provide proof of income, and get a doctor’s signature. But it’s 100% worth the effort if you qualify.
2. Full Patient Assistance Programs (PAPs)
These programs are designed for people who are uninsured or facing financial hardship. If you qualify, the manufacturer may cover the full cost of the drug for up to a year, sometimes longer. The application process can take time, but the reward is often free or deeply discounted medication. Renewals are usually annual.
Why Don’t Pharmacies Tell You This?
There are a few reasons, and none of them are malicious.
Pharmacists are slammed. You’ve seen the lines—we’re juggling prescriptions, phone calls, insurance rejections, safety checks, and counseling all at once. We simply don’t have the bandwidth to Google every drug and hunt down manufacturer coupons for every patient. That part often falls on you… but lucky for you, you’ve got me to guide you. (If you’ve never read my article, it’s one of my most shared blogs: Pharmacists Don’t Just Lick, Stick and Pour).
Another issue? No one can memorize every single manufacturer program. There are thousands of brand-name drugs, each with its own website, rules, exclusions, and fine print. Maybe AI could keep up, but humans? Not a chance.
Insurance plans also change constantly—tiers, copays, prior authorizations, covered alternatives. PAPs update their rules too. What worked last year may not work today. And mostly, the pharmacy staff just doesn’t know a PAP exists. Their training focuses on medication safety, dispensing, and insurance billing—not navigating obscure assistance programs. Technicians often enter the insurance data, so giving them your PAP card or BIN/PCN numbers can actually speed things up.
Just so you know, pharmacists are salaried, so it doesn’t affect their pay one bit whether you’re charged a sky-high price or get your medication for nothing.
But here’s the bottom line: PAPs work. They’re legal. And they can save you a small fortune.
How to Be a Smart, Savvy Patient (I’ve devoted my career to helping you do exactly that)
- Google your medication name plus “savings program” or “copay card.”
- Click ONLY the manufacturer’s website.
- Fill out the quick online form.
- Screenshot the card with the BIN, PCN number, Group number and ID.
- Call the pharmacy and read the numbers.
- Watch the price collapse.
Patient Assistance Programs: The Takeaway
If your prescription ever rings up at a price that makes you temporarily lose consciousness, don’t panic.
Don’t cry.
Don’t sell a kidney.
Just do what I did:
Spend five minutes looking up the drug’s Patient Assistance Program, grab the copay card, and call your pharmacist back with the savings info.
You might save a ton of money instantly. Help your friends and loved ones with this information too. We all need a break on stuff, right?! And yes… you can absolutely brag about this afterwards, and possibly get a sushi roll out of it!
Buy 2 Cheap Medicines Instead of 1 Expensive One!
Let’s take Azor as an example. It’s a brand-name blood pressure medication that combines two well-known ingredients: amlodipine and olmesartan. The cash price for Azor can range from $350 to $450, and it’s only available as a brand. But here’s the thing—both of those ingredients are available as dirt-cheap generics. Amlodipine runs about $3, and olmesartan might cost $10 at most. Don’t quote me on exact prices—that’s not the point. The point is, they’re ridiculously affordable. So why spend hundreds on something that’s basically “two generics in a trench coat pretending to be expensive”?
Knowing this can save you hundreds of dollars at the pharmacy counter, just by asking your doctor to prescribe the components separately.
Sometimes, it’s simply not worth the energy to chase down a savings card or patient assistance program. If the medication has a cheap, perfectly effective generic, just get the generic and move on with your life. Like in the case of hydrocodone/acetaminophen—the generic costs just a few bucks, yet there are brand-only alternatives that cost hundreds (or even thousands) of dollars, offering no meaningful advantage in the real world.
And don’t even get me started on brand names like Duexis or Vimovo—both of which are nothing more than two low-cost generics glued together and repackaged for $1,500 a month. Or Treximet, the migraine drug that’ll run you close to $900, when you could just combine sumatriptan plus naproxen yourself for the cost of a hazelnut latte!
Bottom line? Use your PAP energy wisely. If a generic exists and works just as well, skip the drama and ask your doctor for the more affordable option. You don’t need a patient assistance program to do this. You don’t have to make the decision in the exam room—look it up later, or ask your friendly neighborhood pharmacist. Ask what the drug really is and whether there’s a more affordable way to get the same effect.
Spoiler alert: there almost always is.
If you enjoyed this article about patient assistance programs, and want more ways to save money, read my other blog next, You Can Order Your Own Blood Work and Lab Tests: Here are 6 Advantages!
By the way, if you want to order any specialized tests all by yourself (without having to go to the doctor), just order any lab you want right here at my LAB SHOP. (I’ve partnered with Rupa Health to offer my readers the best tests in the nation, and you can self-order many specialty tests there too).
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.
