Maria Greenwald, MD: Physician Advice for Lowering a Patient’s Cost Burden

In my practice, I commonly get asked “How
much will this cost, doctor?” So, I’m writing the prescription, I make the
diagnosis, but then I’m asked the tough question and I find many times I’m
ignorant because I don’t know how much it’s going to cost this patient. So, in
the last year or 2 we’ve checked to try to come up with ways to save
patients some money and, as much as we can, find out if they can afford their
medication. So, one method is to ask patients to go to, which is
available on your phone, and you put in the zip code and it’ll give you the best
cash price for different drugs. My medication could be $60,000 a year, which
we have to do other things, but I can help them with their statin,
hypertensive drugs, insulin, and all of those add up so that they can put more
money into their deductible or something else. So, it’s a way of making their
medical dollars go farther. Another way is to ask the patient if they’re a
veteran. They don’t always realize it but I can write the prescription (and) if they’re
a veteran I can hand the prescription to them to take to the VA and it’s often
much cheaper for them to do it that way. Another way to do it is to ask the
patients look at the actual prices and they can look through all those prices
and see what might be more affordable for them and they can also talk to—I use
the reference librarian at our public library. So, I send the patient over to
the public library with a list of all the prices of biologics and the
reference librarian calmly and sweetly goes through all the different
medications with that patient’s insurance plan so they can find out what’s on the
formulary. I can’t do that in the office, but the reference librarian is paid by
tax dollars in the community to research things for people who live in the
community and they’ve been very helpful. Another thing is if they’re Medicare you
can ask them to look at all the different plans to see what they can
afford and change plans in October. They may have to change plans every October,
but a Medicare that can’t be turned down—there’s no refusal to cover a Medicare, but
they may have to change which Part D is covering their medications. So, these
different ideas come up you can also ask the patient to check with the
pharmaceutical company that produces their drug to see if there’s patient
support. I can’t predict that, but that’s another thing you can ask the reference
librarian to look up on the computer for your patient.

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