Yesterday I ran the first of a three part interview with former Training and Development Director of Onyx Pharmaceuticals–who is now head of the new Onyx 360 Patient Support Program–Jennifer Sharretts.
Jennifer and her team have worked tirelessly to try and develop a program to help patients and caregivers navigate through all aspects of their treatment journey.
To review, the program is split into three parts: Reimbursement and Payment Support, Clinical Support and Day-to-Day and Emotional Support.
Of course, financial assistance is the cornerstone of the program. Jennifer described how the program was designed to work seamlessly, starting with experienced oncology nurses that answer the phones.
Like Jennifer stated previously, the only financial requirement for aid is that your current annual household adjusted gross income is less than $100,000. Period.
In that case, Onyx 360 will reimburse anything above a $40 per infusion deductible for patients with commercial insurance. In other words, if your insurance deductible is $100 per infusion, Onyx 360 will reimburse you $60 per treatment.
Fair enough. But what about uninsured patients? Even better news here! Recognizing how difficult it can be for families to survive financially when they are uninsured and facing a multiple myeloma diagnosis, Onyx will provide free product to any uninsured patient who makes less than $100,000 a year.
WOW! Pretty generous, don’t you think?
“How can the company afford to do all of this?” I asked. Then it hit me. Kyprolis isn’t a pill like Revlimid. So most insurance companies—and Medicare—pay for 100% of the treatments once one’s deductible is met.
But until then, Onyx 360 can help.
Oops! I mentioned Medicare in the previous paragraph. Jennifer stressed that, “This doesn’t apply to Medicare and Medicaid patients.” “Why not?” I asked. “Federal regulations don’t allow us to provide any financial reimbursement to patients using Medicare or Medicaid.”
Odd, but who can make sense of the endless rules and restrictions that pharmaceutical companies need to follow?
Jennifer did want to stress that, “We can refer federally insured patients who need copay assistance to a non profit foundation like the Chronic Disease Fund, where the patient can apply for assistance for funding from their myeloma specific fund.”
So what about the infamous “donut hole?” “It doesn’t apply here.” Jennifer reminded me. And she’s right! Kyprolis infusions should normally be covered under Medicare Part B.
If you have any questions about anything you’ve read here—or you would like to sign-up for Onyx 360—simply call (855) 669-9360.
Tomorrow I will wrap this up with the third part of our interview that focused on some of the extra things the program has tried to do for myeloma patients–even if they don’t use Kyprolis.
Feel good and keep smiling! Pat