APC Pharmacist Identifies Generic Medication Solution that Makes Adherence Possible

BACKGROUND

Upon being released after hospitalization, many patients with chronic medical conditions are faced with managing multiple new prescriptions, often with complex dosing requirements. When these medications are not covered by current insurance plans, the cost is an out-of-pocket expense for patients. In many cases, these factors make adherence difficult and ultimately unlikely. APC’s pharmacist-driven medication reconciliation can often help identify ways to reduce the cost and complexity of treatment regimens.

CHALLENGE

A patient experiencing chronic heart failure was prescribed a name-brand combination product, which fused two necessary medications into one product. The cost of the required dose of the combination product was in excess of $300 per prescription fill. In addition, the combination product was not covered by the patient’s insurance, which meant the cost of treatment would be entirely out-of-pocket. Both medications were necessary, and it seemed that the combination medication was the only way the drugs were available. With a limited budget and limited coverage, the high cost of treatment made adherence unlikely.

SOLUTION

An APC pharmacist performed a one-on-one medication reconciliation. The pharmacist’s specialized knowledge and training led to an important discovery: the combination medication wasn’t the only option. In fact, a generic alternative of each of the two drugs was available individually. The individual generic medications were both covered by the patient’s insurance, with a total copay for each prescription of only $1. The Pharmacist’s advanced pharmaceutical knowledge was the key factor in identifying an affordable way for the patient to receive the necessary medication.

Case Study Summary:

  • Patient with chronic heart failure
  • Prescribed combination drug at $300 per fill
  • Prescription not covered by insurance
  • APC pharmacist performs reconciliation
  • Discovers individual generic alternatives
  • New copay only $1 per fill
  • Patient now able to remain adherent to treatment

RESULTS

APC’s exceptional reconciliation helped the patient find a significantly more affordable way to achieve the required medication treatment.

With a cost savings of nearly $300 per prescription fill, the patient is now able to afford treatment, and is much more likely to remain adherent. APC’s personalized approach and attention to detail went above and beyond what the patient had experienced upon discharge from the hospital. APC’s “patients-first” approach made the difference.