Shields "Care Corner" Blog

Saving a Patient, and $130,000 in Medication Costs

From a clinic physician - Just before medication therapy was about to begin, Dr. Duplasee discovered that health insurance would not cover the $130,000 cost of growth hormone she prescribed her patient, Lisa. With no options for alternative medications, Dr. Duplasee called her specialty pharmacy care team, located in the hospital clinic, to find a quick remedy for Lisa. Within a week the specialty pharmacy care team, working with the drug manufacturer and insurance provider, secured a year’s supply of growth hormone at no cost to Lisa.


“Very few people know about Foundations and Drug Manufacturer grants,” said Mytsie, a Patient Advocate at Shields who specializes in financial assistance. “In Lisa’s case our on-site Patient Liaison called the financial assistance team because we have years of experience finding financial resources for patients in need. When the insurance provider wouldn’t budge on payment, we searched for grants that might pay the cost. With no available funding for Lisa’s disease state, we went directly to the drug manufacturer. Securing medication for a patient in need can take 20 or more hours of work over weeks of back-and-forth with a physician, patient, insurance provider and drug manufacturer. I’m so glad we were able to help Dr. Duplasee treat her patient with the medication she knew was best for Lisa.”


“The specialty pharmacy team saved my patient,” said Dr. Duplasee. “They also saved my nursing team from dozens of hours of administrative work. Having nurses focus on care rather than forms and faxes helps everyone at the clinic, our patients most especially.”


Subscribe To The Care Corner Blog Here!