Skip to main content
DrugPrice

Patient Assistance Program (PAP)

A manufacturer-sponsored program that provides free or discounted drugs to patients who meet income and insurance eligibility requirements.

How It Works

Patient assistance programs (PAPs) are operated by virtually every major pharmaceutical manufacturer for their brand-name products. Typical eligibility requires U.S. residency, household income below 300-500% of the federal poverty level ($45,180-75,300 single, 2024 FPL), and either no insurance coverage for the drug or documented inability to afford cost-sharing. PAPs provide medications at no charge or at nominal cost, typically shipped to the patient's home or a designated pharmacy. PhRMA's Medicine Assistance Tool (medicineassistancetool.org) and NeedyMeds.org maintain searchable databases; RxAssist.org and the Partnership for Prescription Assistance (RxHope) also provide aggregated access. Individual manufacturer PAPs include the Humira Complete program (AbbVie), Bristol-Myers Squibb Access Support, Merck Helps, Lilly Cares, and Novo Nordisk Diabetes Patient Assistance Program. IQVIA and PhRMA estimated PAPs provided over $20 billion in drug value in 2023, reaching roughly 8 million patients. PAPs are distinct from copay assistance (which serves insured patients with out-of-pocket costs) and from independent charitable foundations like the PAN Foundation. Medicare beneficiaries are generally excluded from commercial PAPs under the Anti-Kickback Statute (OIG treats free drugs as illegal remuneration that could influence prescribing), though some manufacturers operate separate "bridge" or "patient assistance plus" programs specifically for low-income Medicare patients that comply with OIG advisory opinion frameworks. The 2025 Part D $2,000 OOP cap reduces but does not eliminate PAP demand from Medicare patients, as the $2,000 remains a significant burden for low-income seniors.

Related Terms

  • Copay Assistance, Financial help from manufacturers, foundations, or pharmacies that reduces a patient's out-of-pocket cost for a specific drug, typically via copay cards, coupons, or charitable grants.
  • Out-of-Pocket Cost, The amount a patient pays directly for a prescription drug, including copays, coinsurance, and deductible payments.
  • 340B Drug Pricing Program, A federal program requiring drug manufacturers to sell outpatient drugs at significant discounts (25-50% off) to eligible hospitals and clinics serving low-income patients.

Explore Drug Data

Most Expensive DrugsGeneric Drug WatchSearch All Drugs

About This Definition

This definition is part of the DrugPrice Drug Pricing Glossary, 49 terms explaining how prescription drug pricing works in the United States. All definitions are written in plain language for patients, caregivers, journalists, and healthcare professionals.

this entity is one of the U.S. Medicare prescription-drug pricing concepts that recurs across this site. The definition above is the technical answer; the paragraphs below add the practical context for how the concept connects to the CMS Medicare Part D Drug Spending data data behind every per-entity page on the site.

In the CMS Medicare Part D Drug Spending data data, this concept shapes one or more of the fields that drive the per-entity grades and rankings on this site. The methodology page describes which fields feed into which output; this glossary entry documents the underlying term.

Source: CMS Medicare Part D Spending, 2026.