Cory Page PharmD.
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Understand the economic burden of
medications.
Is the newest medication always the best
medication?
Review cost saving measures
 Needy Meds
 Drug Coupons
 Pharmacy Shopping
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Diabetes complications substantially increase
the risk for hospitalization. In 2007, over
24,000 discharges for Utah residents listed
diabetes as any listed diagnosis, with charges
amounting to over $480 million.
Diabetes is the sixth leading cause of death in
Utah. In 2007, diabetes contributed to one
out of every 13 deaths in Utah, or over 1,100
deaths.
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The average patient with diabetes takes 6
medications on a daily basis.
Is asked to test their blood glucose 3 times
daily
Pay usual bills
Has an increased risk of hospitalization
 That hospitalization will cost approximately 30%
more than other patients admitted with the same
diagnosis
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Specifically in Utah County
 Survey of 23 Pharmacies
▪ 6 Independent
▪ 17 Retail
Independent
Retail
Novolog
2 Vial
$
229.56
$
233.46
Lantus
2 Vial
$
205.76
$
210.03
Metformin 1000mg
60 Tab
$
12.93
$
15.75
Amaryl 2mg
60 tab
$
14.67
$
16.06
Byetta
1 box
$
290.50
$
299.39
Victoza
1 box
$
398.85
$
420.65
Januvia 100mg
30 tab
$
212.40
$
219.76
Total
$
1,364.68
$ 1,415.08
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It is important to note that this only accounts for
the cost of medications used to treat Diabetes.
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Not Hypertension
Not Dyslipidemia
Not Depression
Not Neuropathy
Not Nephropathy
Not Pain
Not Anxiety
Not Osteoporosis
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How do we help our patients to save money
and enhance their compliance.
 Ask them if they currently have their medications
at home to take.
▪ Many patients are ashamed to admit they can’t afford
their medication
 Ask them if there has been any change in
insurance and/or employment since their last visit.
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Help them to use their insurance coverage
fully.
Medicare Part D Donut
Hole?
•Initial phase after deductible met
patient pays 25% of drug cost up
to $2830.
•After this amount is reached the
patient is responsible for the
TOTAL drug cost until the out of
pocket expense reaches $4550
•After this amount is reached the
patient is responsible for a co-pay
of $2.40 for each generic drug and
$6.00 for other drugs (or 5%,
whichever is higher).
•Beginning in 2011
•The patient who has reached
the donut hole will only be
responsible for 50% of the cost
of medications
•Beginning in 2012
•The patient who has reached
the donut hole will only be
responsible for 25% of the cost
of medications
•Beginning in 2013
•There will be no
donut hole!
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Medicare Part B helps pay for
 Diabetes screening tests for people at risk of developing
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diabetes
Diabetes self-management training
Diabetes supplies such as glucose monitors, test strips, and
lancets
Insulin pumps and insulin if used with an insulin pump
Flu and pneumonia shots
Foot exams and treatment for people with diabetes
Eye exams to check for glaucoma and diabetic retinopathy
Medical nutrition therapy services for people with diabetes or
kidney disease, when referred by a doctor
Therapeutic shoes or inserts, in some cases
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Medicare Part D helps pay for
 Diabetes medicines
▪ There are plans that do not have a donut hole!
▪ www.medicare.gov
 Plan finder—you can enter in the medications that a patient is
on and find the “best” plan for that patient.
 Insulin, but not insulin used with an insulin pump
 Diabetes supplies like needles and syringes for
injecting insulin (not pump reservoirs)
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www.needymeds.org
 Drug company sponsored patient assistance
▪ Each company has their own program.
▪ Patients who qualify receive their medications for 1 year
free, and then they may re-qualify.
▪ Income based
▪ Signatures needed from provider
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Products include
 Lantus
 Apidra
 Avapro
 Lovenox
 Plavix
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www.xubex.com
 Free medication
 Discounted medication
 Drug company patient assistance
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Government subsidized clinics
 Mountainlands (UT county)
▪ Subsidized healthcare
▪ Office Visits
▪ Medication
 http://www.freemedicalcamps.com/vcity.php?stat
eid=UT
 Drug coupons
▪ Coupons are available for Humalog®, Novolog®,
Januvia®, Janumet®, Lantus®, Onglyza®, Victoza®,
Glucagon®
▪ Many of the coupons are for a free 30 day supply or an
instant rebate at the pharmacy
▪ Medicare or Medicaid individuals may be excluded from offers
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www.needymeds.com
Family of 5 may earn $51,580
Free Medication mailed to the physicians office every 3 months.
 Must fax in refill request form for refills
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Medications include
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Levemir
Novolog
Victoza
Novolog Mix 70/30
Novolin R
Novolin N
Novolin 70/30
Pen Needles
Glucagon Kit
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www.bridgestoaccess.com
 Register to become an advocate
▪ Pharmacist
▪ Nurse
▪ Physician
▪ Family member over 18
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Family of 4 may earn $55,125
Medications for 1 year free of charge in
addition to a voucher for 1 month free at a
retail pharmacy for the medication.
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Medications include
 Avandia®
▪ Avandaryl
▪ Avandamet
 Lovaza
 Antibiotics
▪ Augmentin etc.
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www.needymeds.com
 Family of 5 may earn $55,125
 Medication mailed to physicians office every 90
days
▪ Refills handled by phone
 Medications include
▪ Lantus
▪ Apidra
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Products include
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Accupril
Protonix
Caduet
Calan
Celebrex
Glipizide
Lipitor
Lyrica
Norvasc
Viagra
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Products
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Cialis
Cymbalta
Glucagon
Humalog, Humalog Mix 50/50, Humulin 70/30
Humulin R
Humulin N
Humulin R U-500
Prozac
Byetta
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Freestyle Meter
Freestyle Test Strips
You are a US resident and have a prescription for a Merck
medicine from a doctor licensed in the United States.
 You do not have insurance or other coverage for your
prescription medicine.
Some examples of other insurance coverage include
private insurance, HMOs, Medicaid, Medicare, state
pharmacy assistance programs, veterans assistance, or
any other social service agency support.
 You cannot afford to pay for your medicine.
You may qualify for the program if you have a household
income of $43,320 or less for individuals, $58,280 or less
for couples, or $88,200 or less for a family of 4.
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Januvia
Janumet
Hyzaar
Cozaar
Vytorin