I don't know about you, but I think $2500 is a whole heck of a lot of money, especially to a senior citizen on a fixed income. As much as I bellyache over how stressful my job, it's still my job and if I see an opportunity to help someone, I will.
One of our elderly patients had their caretaker call today regarding a new prescription for Plavix. A one month supply of this particular medication (if paying out of pocket with no insurance) is over $200. Yup. Imagine how bad I felt when I knew this lady was not going to get her medication. She has Medicare but is in the dreaded "donut whole." The "donut whole" is what happens when you have to satisfy your portion of the Medicare deductible. Truthfully, I have no idea how much people have to pay but like everything in life, some people have better plans than other but it's usually at least $1500. After your portion is satisfied, Medicare will again begin absorbing your RX copay and eventually, you'll go for a bit with $0 copay and then the cycle will start all over again. It really is a stressful cycle especially when you have fixed income seniors coming in thinking they aren't going to have a copay and you have to be the one to tell them they've hit their maximum (the donut hole) and now they have a $400 copay (which they can't afford) . It sucks.
Anyway, I realized today that patent X was in the donut hole and after offering to go online and try to find manufacturer coupons or to check for programs for her, I thought to ask if she recently had a stent put in. No she did not. Plavix is used to avoid blood clots (among other things) and the doctor wrote for this drug first without even considering simple aspirin therapy. Honestly, most doctors just don't think or even realize how expensive these medications can be and are too quick to write a script. Since, patient x has never taken this medication and it was being used for stroke prevention, I told her caretaker to call the doctor and explain she could not afford the med and ask her if she could try aspirin therapy. A few minutes later the doctor calls the pharmacy and she and the pharmacist agree this seems to be the best course of treatment for patent x both medically and financially.
If patient x has to buy two economy size bottles of aspirin this year totaling $10, that means I helped her save almost $2500 by having her therapy changed to a simple aspirin. I have to say, it feels really good knowing I've spared someone a huge financial burden while allowing them to improve their quality of life.