From a Specialty Pharmacy Liaison – A patient called me Wednesday morning in a panic. He hadn’t received his shipment of Hepatitis C medication and he was going run out in just two days. A two- or three-day lapse would likely mean he wasn’t going to be cured as so many others had been on the medication.
When we looked up the shipper’s tracking information, we confirmed the package of medication was delivered to the correct address. Since the medication is very expensive we realized it was likely stolen before the patient arrived home from work. Faced with only having two days of medication left for a therapy that costs more than $30,000 the patient didn’t know what he was going to do.
I quickly called the patient’s insurance provider to see if an emergency override could be performed for stolen medication. The insurance provider refused the override stating the patient needed to file a claim. An understandable request, but the challenge was the patient would be out of his medication before the claim could be settled. If he chose to borrow some of money and put the balance on his credit card, he ran the risk of insurance not paying at all.
After working with the patient to file a claim and again having his insurance refuse the override, I asked our team of financial assistance experts to contact the pharmaceutical company and see if the patient qualified for an emergency prescription fill through its foundation. Finally, after two days of work, at 4:30 on Friday, the foundation agreed to send out the medication for free, delivered on Saturday, so the patient wouldn’t miss a single dose. The patient was incredibly grateful for the hard work of our specialty pharmacy team and for the generosity of the drug manufacturer. We were all delighted that the patient was again on his way to being cured!