Real World Health Care Blog

Tag Archives: pharmaceutical

Five Ways to Manage the Costs of Your Medicine

While a main precept of the Affordable Care Act is to expand access to health care, in some cases that improved access means more patients are being treated with medications that come with a cost. As a pharmacist, I have to be an insurance sleuth, use common sense, and teach my patients the old-fashioned methods of negotiation.

Joel Zive

Joel Zive

I work in solid organ transplant, HIV, and Hepatitis C medicine. I have patients on regimes ranging from 4 to over 20 medications. For my patients, obtaining consistent, reasonably-priced medications – both over-the-counter and prescription – is vital.

1. Make sure all the medications are at one pharmacy.  It’s important to keep a clinical eye on things for drug interactions. As a bonus, the pharmacist and the patient know what costs need to be examined.

2. Seek out insurance prior authorization.  Some insurance companies require prior authorization to cover certain drugs. Your pharmacist can help you seek prior authorization for medications that require it using software that creates forms specific to each insurance company. Ask if your pharmacist can fill out the form as much as possible before sending it to your doctor.

3. Contact the drug company.  Many pharmaceutical companies offer patient assistance programs or co-pay assistance cards to help eligible patients obtain free medicines, particularly for biologics and expensive drugs. These programs are especially helpful for patients who have insurance gaps and need the medications quickly. Depending on the assistance from a case manager or care coordinator, I have received authorization for medications right away or within 72 hours.

4. Search for a co-pay assistance program that covers your condition.  If your drug company does not offer a patient assistance program or you are not eligible based on your income and insurance coverage, it is possible that a charitable patient assistance program through a non-profit organization such as the HealthWell Foundation may be able to help you.

5. Seek discounts for over-the-counter medications.  Over-the-counter medications can put a strain on the wallet. In many cases, purchasing over-the-counter medications is more expensive than prescription medications covered by insurance. Other items like vitamins, natural supplements, and enteral formulas (also known as ‘milks’) require the patient to do a little negotiating. If you tell the pharmacy or vitamin store you will be taking these items indefinitely, they may be inclined to discount. Also, be on the lookout for buy one get one deals (BOGOs). Finally, enteral formulas can be quite expensive, so if you get prescribed a specially formulated one, ask if you can take a more basic formulation instead. Remember to let your prescriber and pharmacist know which over-the-counter medications and supplements you are using.

In conclusion, while the path to affordable medications is not always easy, there are individuals, programs, and strategies that can help you meet your health care goals.

How do you manage your medications? Share your tips in the comments section.

Categories: General

More Patients DASH to New Solution to Reduce High Blood Pressure: Part I

Shawn_J_Green

Shawn J. Green

What’s the solution to reversing the tide of hypertension, the most commonly diagnosed condition in the United States?  More evidence indicates that the answer begins with the food choices we make every day.

An underlying cause of heart attacks, strokes and kidney disease, one in three American adults now experiences high blood pressure – the single-largest contributor to death worldwide. It is also becoming more resistant to the pharmaceutical drugs used to lower it. In fact, blood pressure remains elevated in nearly one-third of all treated hypertensive patients on pharmaceutical drugs.

Instead of relying on prescriptions, more patients are turning to a healthier eating approach: Keeping sodium intake low and making consumption of nitric oxide-rich vegetables and leafy greens high. This cardio-protective daily diet, known as the DASH (Dietary Approach to Stop Hypertension) Eating Plan, is emerging as an effective way to delay or prevent high blood pressure altogether.

The value of nitric oxide was spotlighted when the Nobel Prize was awarded in 1998 for discovery of this naturally produced cardio-protective factor. A string of clinical studies underscored that vegetables (like red beet roots) and leafy greens (such as spinach and arugula) are replete with nitric oxide.

Diets known for promoting heart health and lowering rates of diabetes and obesity – like Japanese diets, Mediterranean diets and plant-based diets, such as DASH, among others including TLC, Ornish, and Pritikin – incorporate these natural whole foods. The need to consume more nitric oxide-potent vegetables and leafy greens becomes even more critical as we age because our bodies are less able to synthesize this natural hypertensive-fighting factor.

Reducing hypertension would not only improve health outcomes for individual patients, but would also benefit the health system as a whole. Although the percentage of resistance to antihypertensive drugs is relatively lower in the U.S., elevated blood pressure among a rapidly growing number of baby boomers will mean more challenges for health care in the long run unless we identify tools that work and make them as accessible and user-friendly to the public as possible.

DASH holds great promise to fuel compliance – a critical driver to prevent elevated blood pressure – among those living with hypertension. But a healthful eating strategy alone will not mean better outcomes for patients without a model to help them break bad habits and support dietary changes on a personal level, one day at a time.

So how do we get there?

Join us here next Thursday for the second post in our two-part series. Discover what innovative tools can empower patients to make the DASH Diet a part of their arsenal in the fight against hypertension.

With a Little Help from My Friends, Family… And Apps

“Drugs don’t work in patients who don’t take them.” – C. Everett Koop, former Surgeon General

It was an idea born of near tragedy: an elderly, diabetic father who double-dosed on his insulin therapy and suffered a medical emergency. His two sons realized that if they were more involved in reviewing their father’s daily medication and insulin regimens, it could change his behavior for the better and help him get healthier.

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Photos courtesy of NextGen Healthcare

So Omri and Rotem Shor co-founded the MediSafe Project, a free mobile app that makes it easier for families and friends to give the support needed to help their loved ones get healthier and integrate healthier behavior modification into their everyday lives. In the first four months after its launch, users reported medication adherence rates of 79 percent (82.25 percent for statins) – well above the 50 percent average medication adherence rate reported by the World Health Organization.

The MediSafe Project provides an easy-to-use interface – an interactive pillbox of sorts — over iOS and Android mobile phones. Users input information about their meds by typing their names or photographing their National Drug Code numbers. The system stores the correct pharmaceutical name, manufacturer and dosage, ensuring an error-free medication list in the event of a medical emergency. Users signify taking their meds by dragging pills from the virtual pillbox into a mouth icon, which “swallows” the pills.

Users receive alerts before medication courses are completed, allowing them to order refills in a timely manner. In addition to reminding users when it’s time to take their medication, the MediSafe Project sends alerts to selected family members, friends and caretakers when a loved one misses a dose. Users can also email a personalized list of adherence stats to their doctor, giving doctors better patient oversight between office visits. A prescription page feature lets doctors “prescribe” the MediSafe project to their patients to help better monitor medication adherence.

The impact of non-adherence on the outcomes of patients with cardiovascular diseases is one example that underscores why it is so critical to implement strategies and utilize technologies that improve medication adherence.

“Medication non-adherence is a problem that costs U.S. hospitals billions of dollars every year,” says Omri “Bob” Shor, CEO, MediSafe. “An American dies every nineteen minutes from skipping or taking medication incorrectly. Our goal is to help combat this problem and encourage healthy habits among users and their support systems with easy-to-use technology.”

The MediSafe Project isn’t the only app on the medication adherence scene. The free NextGen® MedicineCabinet app lets users create and update a list of medications, including dosing and schedule information, thus creating their own “personal” medication record.

Notifications are sent for each medication and users can confirm adherence. The app was designed, in part, to improve adherence and proper use of medication by enhancing patients’ understanding of how to correctly take their medication and to recognize adverse reactions. According to the company, it also equips health care professionals with all the relevant information they need, in a way they like to view it.

“Mobile patient engagement is at the forefront of today’s changing health care environment,” said Ike Ellison, executive vice president of business development for NextGen Healthcare, in a statement. “Providing consumer technology that encourages members to control and lead healthier lifestyles is a key factor in improving outcomes.”

Michael Paquin, vice president, business development for NextGen Healthcare, added “One of our users commented on the way that she was able to, for the first time, be able to share her medication lists easily with family, friends and all her physicians. It has saved this particular patient hours of time on a monthly basis.”

Technology-based solutions like the MediSafe Project and the NextGen Medicine Cabinet are among the latest patient-directed tools that improve medication adherence.

However, providers still play an important role in assisting patients in maintaining healthy behaviors like medication adherence. The American College of Preventive Medicine offers a SIMPLE approach on how providers can help their patients take their medications as prescribed.

Barriers to medication compliance abound, with memory issues, lack of support, and lack of education just being a few. What is behind these barriers? How can patient behaviors and motivations be changed?

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Categories: Access to Care