Q. I had a heart transplant and now I can’t afford the medicines because I am in the doughnut hole. If I stop taking the drugs my transplant will most likely fail.

I fall in the cracks because I get too much money for any kind of government help but I can’t make it through the gap on my own. I would like a copy of your guide to saving money by getting prescriptions filled in Canada.

A. After a transplant, patients like you need to take powerful (and pricey) medications that prevent the body from rejecting the transplanted organ. If you are taking a medication such as Prograf (tacrolimus), we can easily understand how difficult it could be to pay the bill on your own. It might cost $500 or more for a month’s worth of medication.

In Canada, the generic form is available for about half that much. Although drugs you buy in Canada are not eligible to get you out of the doughnut hole, it still might make economic sense. You would have to spend over $3,000 out of pocket to get Medicare to pick up the tab on the other side of the hole.

Not all online drugstores that claim to be Canadian are legit. Since you can’t risk taking counterfeit drugs, we are sending you our Guide to Saving Money on Medicine with a discussion on how to evaluate online Canadian pharmacies, tips on finding free medicine and ideas on using generic drugs wisely.

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  1. Beth

    My son had a transplant 4 years ago since then, he has lost emplyment and NONE of the so called assistance programs help him because he made too much money 8 months ago…..before his job ended… thsee are all boggus…..if doctors and insurance and others really cared about transplant patients, there would be real help.
    Before anyone says we haven’t done this or that…..shhhh…..we have and even the coordinator has but there is nothing g. So what happens now? Someone’s loved one gave an organ for not…..just saying ……someone, somewhere should make it illegal for patients who cannot afford anti rejection meds to be denied life saving meds. We struggle to get his meds now selling everything we can, working xtra…..etc……this is rediculous …..someday, he may. Not be able to get the meds and die….grrrr

  2. Melissa

    My father had a kidney transplant 4 years ago, and he hasn’t had any problems with his medical insurance… until now. He has horrible coverage through his job and none of his transplant medications are covered. His prograf is not covered, his nexium is not covered, nothing is covered and like many others I have read my parents make too much for any assistance. How are people suppose to survive and live when they can’t afford the medications that they need.
    Any suggestions will be much appreciated. I hope we can all find the help we need.

  3. Carole

    I had a blood stem cell transplant for acute mylogenous leukemia (AML). I take both Prograf (tacrolimus) and Rapamune (sirolimus). I am disabled and on Medicare. Both drugs were 100% covered under Medicare Part B. Yes, Part B, not Part D. No co-pay.
    The last 2 months, Rapamune has not been 100% covered — there is a $199 co-pay, which is being picked up by Medic-Aid, with a nominal co-pay. My Part D plan does not cover any of this.
    Does anyone know why all of a sudden it’s not 100% covered by Part B?

  4. RLO

    Patient assistance programs for me have not been so helpful. You file a huge packet of information, then they come up with something else they need, rather then just requesting the additional information they deny your request and return the entire packet for you to start over.
    In my case they needed a letter from my previous employer stating why my position ended– I could have never forseen that one. Anyway it took two weeks to receive the packet back then I returned it immediately, then they denied it because I did not have the original letter from unemployment stating what my benefits are (although I did send them a printout from the internet giving that information).
    So again I am in the hold mode, this all started six weeks ago. I am in the doughnut hole have no drug coverage and not eligible for any other coverage because of my $345.00 a week unemployment. But yet my drug bills run $1400.00 a month. I think patient assistance is a bit of a joke, they are required to do it or at least say they are doing it but it cuts into profits.

  5. ML

    It’s great that the drug companies are willing to help the elderly and the low income with the cost of drugs. I am just above the low income limits, but I take four anti-rejection medications every day. I had a bi-lateral lung transplant in 2005. Insurance has paid for my meds so far, but my insurance is now running out. (I have been on medicare and cobra for three years).
    There is no way I can afford these meds on my own. Especially in the donut hole.

  6. VG

    As Heidi R. commented, there is help available. Before I got my full-time job which has good health and drug insurance, I was able to get my $10./day Arimidex tablets for free from the Astra Zenica Pharmaceutical Company because they have a patient assistance program.
    Your income determines your eligibility. The social worker at the cancer center was very helpful with all of the paperwork and I always will be grateful to him and the cancer center and to the Astra Zenica Company.

  7. Heidi R.

    I am a transplant social worker and as such assist my patients frequently with this issue. There are entities on the Internet, such as helpingpatients.org, that will assist patients to get medications. In addition, the pharmaceutical companies themselves have patient assistance programs, especially for immunosuppressant drugs. I strongly recommend that this patient speak with the social worker that they should have seen prior to transplant to assist him/her with finding and getting hooked up with these programs, or to ask the hospital where the transplant was performed for a referral to a social worker.

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