What is Patient Assistance Program (PAP)?

The Patient Assistant Program (PAP), also known as the Manufacturers Assistant Program, is a critical resource used to manage the high costs of specialty prescriptions. This program provides savings, often covering the entire cost of a prescription. However, PAPs are income-based and do not apply to all specialty medications.  

To illustrate this program’s importance, consider someone needing Dupixent, which costs approximately $49,492 annually. Through a PAP, the entire cost could be covered, potentially preventing someone having to choose between paying for life-saving medication and making rent.  

During the last legislative session, the Tennessee General Assembly tried to pass a bill that would’ve restricted this vital tool. While the intention may have been to regulate certain healthcare intermediaries, the potential impact would have been detrimental to employers striving to support their employees and to individuals who rely on specialty medications while trying to make ends meet.  

While legislators did not intend to hurt Tennesseans, that would have been the consequence of eliminating the PAP option. This is a common theme. TEBA has seen negative unintended consequences with prior efforts to limit employers’ ability to manage their own benefit plans, including the passing of artificially inflated dispensing fees and laws that preempt ERISA protections. These laws, intended to supplement the income of low-volume pharmacies, end up burdening businesses and, ultimately, families.

Understanding the role of healthcare intermediaries and programs like PAPs, which help Tennessee businesses make decisions that benefit both their employees and their financial health, is crucial. A lack of understanding can cost Tennesseans hundreds of thousands of dollars, and negatively influence the decisions made by the Tennessee General Assembly.