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Executive Summary

Bristol-Myers Squibb's Cardiovascular Access Program for indigent patients has provided products to 1,265 patients through nearly 15,000 physicians enrolled in the program as of Aug. 1, 1992. The company initiated the program in March of this year and is using its sales force to disseminate information on the program and to enroll physicians. The program provides free-of-charge products from Bristol-Myers Squibb's cardiovascular drug line, which includes Capoten, Capozide, Corgard and Pravachol, to indigent patients recommended to the program from enrolled physicians. Although patient enrollment in the program initially was slower than Bristol-Myers Squibb expected, the company said the number of patients participating in the program recently has begun to show "steady, gradual growth." The Cardiovascular Access Program is one of four Bristol-Myers Squibb programs that provide products free-of-charge to indigent patients. A directory of such programs released by the Senate Aging Committee on Aug. 10 reports that the three other BMS programs enrolled over 6,400 patients in 1991. For a number of years, Bristol-Myers Squibb has provided free cancer drugs and selected products from its prescription product line to indigent patients who are eligible for the company's programs. Last autumn, the company launched an indigent patient program for its AIDS antiviral Videx (ddI). That program had enrolled 75 patients at the end of 1991, according to the Senate report. The four BMS programs are among 41 indigent patient programs offered by 35 companies included in the Aging Committee directory. The directory was compiled by Sen. Pryor's (D-Ark.) Aging Committee staff from a survey sent to 36 drug companies in March ("The Pink Sheet" April 13, T&G-2). PMA announced the availability of its own directory on July 24 ("The Pink Sheet" Aug. 10, T&G-4). The Senate Aging Committee report, entitled "A Status Report: Accessibility and Affordability of Prescription Drugs for Older Americans," focuses on drug access for the elderly and includes the manufacturer indigent patient programs as an appendix (see following story). The Pryor report primarily differs from the PMA directory in its focus on patient accessibility to programs; the PMA's brochure is directed at physicians. The Pryor report specifically mentions products covered in each of the manufacturers' programs, unlike the PMA report, and presents the information on the programs in a "user-friendly" format. The Pryor report is being circulated through national patient advocacy organizations, associations for the elderly, such as the American Association for Retired Persons, medical professional and specialty organizations and congressional offices. Committee staff said that they have received a "tremendous response so far in terms of requests" for the report. The Aging Committee report also differs somewhat from the PMA directory in terms of companies listed. The PMA directory lists 44 companies and 59 programs, including multiple listings for several companies that are condensed into one listing in the Pryor report. In addition, the Pryor report does not have listings for Lederle or J&J's McNeil and Ortho subsidiaries, which have indigent programs, but, according to the report, were unwilling to list products covered in the programs in the committee's directory. Based on company responses to the survey, the Aging Committee report indicates that the most far-reaching indigent programs currently are offered by Searle and Marion Merrell Dow. Since announcing the inception of its "Patients in Need" program in 1987, Searle actively has publicized the program, which distributes certificates free-of-charge for selected products to physicians who distribute them to needy patients. According to the Aging Committee report, Searle said it has distributed "nearly 5 mil. certificates worth $150 mil." to physicians since 1987. Marion Merrell Dow reported to the committee that its indigent patient program has grown dramatically since 1989 when the company received and honored 15,000 requests for products covered by the program. Last year, Marion Merrell Dow received and honored 150,000 requests for products, according to the committee's directory.

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