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Developed world

Access to medicines is not just an issue for the developing world. Even in developed countries some patients cannot afford the medicines they need. This is a particular problem in the US where many people do not have health insurance. GSK has developed Patient Assistance Programs and discount cards in the US to help patients without insurance.

We are also introducing discount cards in several middle-income countries to enable qualifying patients to obtain prescription medicines at a discount price.

Programmes in the US
Patient Assistance Programs provide prescription medicines to low-income, uninsured patients free or at minimal cost. GSK operates several programmes, including Commitment to Access which covers cancer treatments and Bridges to Access which covers other medicines for outpatients. Patients are registered through one phone call from a patient advocate and receive medicine at their local pharmacy or by mail order. In 2005, 565,000 patients received GSK medicines worth $463.8 million through these programmes, compared with $372.5 million in 2004. The value of the medicines is calculated using the wholesale acquisition cost (WAC).

GSK was the first pharmaceutical company in the US to offer a card providing savings on medicines to low-income senior citizens and disabled people. Known as the Orange Card this enabled these people to buy GSK outpatient prescription medicines at a discount of up to 40%. In 2005, 205,672 Orange Card holders received 49,084 prescriptions, saving $5 million (based on WAC).

In 2002, GSK and six other pharmaceutical companies established the Together Rx card which provided discounts on over 155 prescription medicines for low-income senior citizens who are eligible for Medicare. In 2005, 347,835 people received 463,901 GSK prescriptions through this programme, saving $7.5 million (based on WAC).

Our access programmes in the US will change significantly in 2006 with the launch of a new Medicare prescription drug coverage programme. The Orange Card and Together Rx programmes finished on 31 December 2005 as those patients are now eligible for the new Medicare programme. We will report on the roll-out of these changes next year.

In January 2005, GSK and nine other pharmaceutical companies created a new card to improve access to medicines for other uninsured Americans, not just seniors. The Together Rx Access card provides savings of 25-40% on more than 275 medicines. Approximately 36 million people, around 80% of uninsured people in the US, are eligible to enrol. The participating companies enrolled 353,113 people in 2005, who received 647,227 prescriptions worth $10.1 million (based on WAC). GSK assisted 10,947 of these patients, with 31,617 prescriptions, worth $2.9 million.

Orange Cards in middle income countries
In 2004 GSK introduced Orange Cards providing discounts on certain GSK prescription medicines for eligible patients in Bulgaria, Lithuania and Ukraine. The nature of the discounts varies between countries, depending on the needs of the patient and the way in which the healthcare system operates.

Our Orange Card in the Ukraine gives all asthma and chronic obstructive pulmonary disease patients who are under 25 or over 50, an average discount of 19% on GSK’s Seretide asthma medicine. Asthma patients of any age who suffer disabilities or who are affected by the Chernobyl nuclear disaster are also eligible. Eligibility is assessed by the patient’s doctor and patients can receive the medicine at participating pharmacies. A hotline number has been set up to help patients find their nearest pharmacy. In 2005, 3,500 patients enrolled and received discounts worth $176,000.

In Lithuania, our Orange Card gives senior citizens an average discount of 40% on the patient co-payment on all GSK prescription medicines. So far more than 12,000 patients have applied for an Orange Card and 155 pharmacies are registered to participate. In 2005, 3,000 patients received discounts worth £20,000 ($36,400). In December we widened the group who are eligible for the Orange Card to include disabled people.

A GSK Orange Card was also introduced in Bulgaria in May 2004 for low-income patients with chronic diseases such as asthma, chronic obstructive pulmonary disease and diabetes. Card holders receive an average 35% discount on four GSK prescription medicines. In 2005, 36,000 patients received discounts worth over Euro 1.4 million ($1.75 million)

Summary of GSK discount programmes
Country	GSK Programme	Number of Patients	Value of Benefit to Patients
US	Patient Assistance Programs - Free or minimal cost medicines for low-income, uninsured patients.	565,000 received prescriptions	$464 million
US	Orange Card - Discounts for low-income senior citizens and disabled people.	205,672 received prescriptions	$4.992 million
US	Together Rx - Discounts for low-income senior citizens. Joint industry programme.	347,835 received prescriptions	$7.561 million
US	Together Rx Access - Discounts for all low-income uninsured patients. Joint industry programme.	10,947 received prescriptions	$2.912million
Bulgaria	Orange Card - Discounts for low-income patients with chronic diseases.	36,000 patients received prescriptions	$1.75 million
Lithuania	Orange Card - Discounts for senior citizens and disabled people	12,000 enrolled	$36,400
Ukraine	Orange Card - Discounts on asthma medicine for patients under 25 or over 50.	3,500 enrolled	$176,000

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