Prescription Assistance Program Denial

This evening, I brought the trash and recycling outside. On my way in, I checked the mailbox; there was some junk mail and a letter from Johnson & Johnson Prescription Assistance Program. I’ve been waiting for this letter. I held it in my hand as I walked quickly to get inside my house so I could open it and hopefully find out that they accepted my application.

I opened the letter quickly and started reading. It says, “Thank you for applying to our Patient Assistance Program…Unfortunately, after carefully reviewing your application, we’ve determined that you do not meet the eligibility requirements at this time…” The second I read the word “Unfortunately” I knew they were rejecting my application. This is very upsetting for me. The medication is for a bladder condition I have called interstitial cystitis. It’s very painful and causes many bladder problems. The medication was going to give me the possibility of no longer doing installations (catheterization to insert medication directly into the bladder). I do these installations every week.

The medication costs $500 to $800 per month without insurance. With my insurance coverage, it costs $230 per month. While the insurance does cover quite a bit of the cost, there’s still a lot left to be taken care of, especially since it would be in addition to all of my psychiatric medications. The letter gave several reasons why they may have denied my application. The only one that seems to fit is that you need to be uninsured for the prescription product needed. Even though my coverage for this medication is crappy, it’s still there, and that’s what they are basing their decision on.

This sucks, and is ridiculous (sorry, just venting). This is not the answer I was looking for, but I will have to deal with it. Maybe I’ll try the medication for a couple of months to find out if it would even work. If it does work and I want to continue taking it, then I can figure out how to deal with it at that time. If it doesn’t work, then there’s no reason to be stressed and upset about it. I’m going to have to think about it for a little while before making a decision.