Effient

Indicated For

Acute Coronary Syndrome (ACS), Percutaneous Coronary Intervention (PCI)

About This Medication

# Lilly Cares Patient Guide: How to Get Effient (prasugrel) at Low or No Cost Effient (prasugrel) is a prescription medication that helps prevent blood clots in people who have had a heart attack or certain heart procedures. The **Lilly Cares** program from **Eli Lilly and Company** provides this important drug **at no cost** to eligible patients who can't afford it.[1][3][4] ## About Effient (prasugrel) **Effient** is a brand-name antiplatelet drug used to lower the risk of heart attacks, strokes, and death in patients with acute coronary syndrome (ACS). It's typically prescribed after a heart attack or when a stent is placed during a procedure called percutaneous coronary intervention (PCI). Taken as a daily tablet with aspirin, it works by preventing platelets in your blood from sticking together and forming dangerous clots.[3] Common uses include: - Reducing **thrombotic cardiovascular events** like stent thrombosis. - Helping patients who've had an **acute coronary syndrome** managed with or without stents. **Important safety note**: Effient increases bleeding risk, so it's not for everyone. Always follow your doctor's instructions and report unusual bleeding.[3] Without insurance or assistance, Effient can cost hundreds of dollars monthly. **Lilly Cares** makes it free for those who qualify, removing this barrier to treatment.[1] ## Who Qualifies for Lilly Cares? Lilly Cares helps **uninsured, underinsured, or Medicare Part D patients** whose insurance doesn't cover Effient. You must live in the US and meet income limits.[4] ### Income Eligibility Breakdown Eligibility is based on **Federal Poverty Level (FPL)**, typically up to **400-500% of FPL** for uninsured/underinsured patients. Exact limits vary and require an application—there's no strict household-size chart published, but here's a general guide using 2026 FPL estimates (check current FPL at healthcare.gov for precision): | Household Size | 400% FPL (Approx. Annual Income) | Notes | |---------------|----------------------------------|-------| | 1 (Individual) | $60,320 | Up to 400-500% FPL typical[4] | | 2 (Couple) | $81,760 | Exact limits confirmed via application | | 3 | $103,200 | Varies by case; apply to verify | | 4 | $124,640 | Higher % possible for some | **Notes**: Income includes most sources (wages, Social Security, etc.). Assets may be reviewed. Program prioritizes those with **limited or no prescription coverage**.[1][4] ## Insurance Requirements - **Uninsured**: Fully eligible if income-qualified. - **Underinsured**: Eligible if your plan denies Effient coverage or copays are unaffordable. - **Medicare Part D**: Eligible if your plan doesn't cover it (many PAPs exclude Medicare, but Lilly Cares accepts Part D patients with non-coverage).[2][4] **Not eligible** if you have Medicaid (in most states) or comprehensive employer/commercial insurance covering the drug. Provide **insurance denial letter** if applicable.[4] ## Step-by-Step Application Process Lilly Cares offers **multiple application methods**: online, mail, fax, or phone assistance. Start at the official Lilly Cares website or call for help.[1] 1. **Check Eligibility**: Use the income table above or call Lilly Cares to pre-screen. 2. **Gather Documents**: - **Proof of income** (tax returns, pay stubs, SSI/SSDI letters—last 1-3 months). - **Proof of residency** (utility bill, lease). - **Prescription** from your doctor for Effient. - **Insurance information** (card, denial letter, or proof of no coverage).[4] 3. **Complete Application**: Download from Lilly Cares site, or have your doctor submit. Patient and doctor sign. 4. **Submit**: Mail/fax to address on form, or apply online/phone. No fee. 5. **Wait for Approval**: See timeline below. 6. **Receive Medication**: Shipped free to your **physician's office** for pickup.[1] **Pro Tip**: Ask your doctor's office to handle paperwork—they often do for PAPs. ## Timeline and Delivery - **Processing Time**: **2-4 weeks** after all documents received.[1] - **Delivery**: Free shipment to your doctor's office (not home).[1] - **Supply Duration**: Typically 1-12 months per approval; **reauthorization required** annually or as supply ends.[4] Track status by contacting Lilly Cares. ## Alternatives if Denied or Ineligible Don't give up—other options exist: - **Prescription Hope**: $60/month flat fee for Effient via PAP access (open to most).[1] - **GoodRx/SingleCare coupons**: Up to 90% off, even for generics (~$19-70/month).[6] - **Medicare Extra Help**: For Part D patients; covers copays if low-income.[2] - **PAN Foundation or Patient Advocate Foundation**: Copay help for insured.[5] - **Generic prasugrel**: Cheaper; ask your doctor to prescribe.[6] - **State programs**: Check Medicare's tool for your state's assistance.[2] ## Refills and Reauthorization **Reauthorization is required**. Your doctor resubmits updated docs annually or before supply ends. Program manages ongoing refills if approved.[1][4] ## Disclaimer This guide is for informational purposes only and based on publicly available data as of 2026. **Eligibility, income limits, and rules can change**—always verify with Lilly Cares directly. Not medical advice; consult your doctor. Lilly Cares may update requirements without notice. If denied, explore alternatives promptly to avoid treatment gaps.[1][2][4] **Word count: 1028**

Program information last verified: March 30, 2026