Shields "Care Corner" Blog

Doing The Right Thing Pays Off

James, a patient suffering from a GI related chronic illness, recently transferred his specialty medication over to his local hospital specialty pharmacy. When his pharmacy liaison met with him, she noticed that he needed a new prior authorization done pretty urgently because he was a week overdue for his medicine. Once James’ Liaison had obtained the prior authorization, she let the clinic know and asked them to inform her when James was all booked for his next appointment. James received a phone call from his Liaison the next day informing him of the prior authorization approval and letting him know about the financial assistance program that the hospital specialty pharmacy offers, which ensures that no patient pays more than a $5 copay for their specialty medication. His liaison asked if he was signed up to receive financial support from the drug manufacturer or from his former pharmacy. To the liaison’s surprise, James had never heard of that and didn’t even know that was even an option for him. James’ liaison explained to him that the drug manufacturer of the specialty medication he takes, offers a financial assistance program that would allow him to take his medicine for only a $5 copay. James was amazed that there was financial support available to him and that he wasn’t even aware of it before his liaison mentioned it to him. He mentioned to his Liaison that back in May, he paid $2,500 for his medications due to his insurance deductible. Hearing this and knowing that James needed support, his liaison suggested that James sign up for the program and they worked together to submit a reimbursement claim so that he could be refunded for the expensive medication back in May. As of this week, James received a reimbursement check ultimately saving him $1,979.60! Without his Liaison he would never have known about the financial support that was available to him and would have faced a tremendous hardship going forward. James thanked his liaison for all of her support and advice in helping him navigate this confusing process and he’s looking forward to getting back on track with his medication.

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