[NurseNature]

Teachers and books keep teaching students to assess the pt's financial situation as to whether or not they can afford the meds/treatments. Cool... what are we to tell them once we figure out they can't? I live in a suburb of a medium sized city. In the county of the city there are resources. If you make less than $15,000/anually there is help. What about those that make $15,001? What about the people in surrounding cities and rural areas without such programs? I can't find poop on the internet and I am fairly computer savy. What am I to tell these pt's that deserve to be helped? I have a friend of age 55 who cannot afford his blood pressure medication and makes barely enough to keep a one bedroom apt. I want to help him but I cannot find a way. Any suggestions?

[grammyr]

If there is a WalMart around, there is a list of drugs that can ge gotten for $4. for a 30 day supply. There is a website called www.needymeds.com that can help with other meds via the drug maker. Check them out and there may be help for him.

[motorcycle mama]

St. Thomas Infirmary based out of Nashville has a program where they collect unused, unexpired medications from doctors' offices to distribute to the poor.
The average doctor's office throws away $30-60K worth of samples every year, so this is a good program.

[santhony44]

Originally Posted by grammyr

If there is a WalMart around, there is a list of drugs that can ge gotten for $4. for a 30 day supply. There is a website called www.needymeds.com that can help with other meds via the drug maker. Check them out and there may be help for him.

Those are both excellent resources.

Some drug assistance programs require that the provider fill out and/or sign the paperwork. Occasionally you'll find a provider who won't do it. (It's a pain in the rear). I'd suggest that, if your friend is in this situation, he needs to find a provider more responsive to his needs.

Also, if he's paying a lot for his office visits and so forth, he needs to look around and see if there is a sliding scale clinic in his vicinity. I worked for one where patients on the lowest income scale paid one price for an office visit, including any needed labs. The clinic also had a limited pharmacy and had someone whose job it was to help patients get meds through the drug companies.

Sometimes there are resources out there if you just know how to find them.

[awsmom8]

Kmart also has a $4.00 RX program and some of the meds are different than Walmarts. Costco has better prices than pharmacies. Look up www.pparx.org (Partnership for Prescription Assistance) and they have low cost or no cost meds.
Another cost saving technique is to have MD write for double to dose and take 1/2 a tab--if the tab is scored and can be safely taken that way. The pharmacist will know if it is safe. For example, there is only a few cents difference between Lasix 40 mg and Lasix 20 mg., and by cutting a 40 mg in half it will cost a lot less than buying a 20 mg tablet.

[grammyr]

As case manager at my hospital, I fill out the paperwork and all the doc has to do is sign and write the script. We try to utilize the samples from the clinics or try to find another med that will do the same job for less money.

I have the Wal-Mart list taped to my wall so if a patient has questions all I have to do is look at the list. It has been a big help for a lot of patients.

[morte]

others have covered most of my thoughts, however the first thing to do would be to ask doc if there is a cheaper alternative....good luck

[Emmanuel Goldstein]

Originally Posted by morte

others have covered most of my thoughts, however the first thing to do would be to ask doc if there is a cheaper alternative....good luck

Good idea. Had a older lady some years ago who was ordered Zofran po for chemo-related nausea. The retail cost for the 7 pills he ordered was over $1100. Yeah. $1100. That is not a typo. I thought her daughter was going to faint. I suggested they call the doc to ask if she could try an older (cheaper) alternative. Turns out she did just fine on po compazine. The costs of these meds is just obscene.

[ZippyGBR]

encourage the docs to prescribe generically

encourage the docs to think about the stuff like splitting pills as others have said many tablets can be succesfully split - most uncoated tablets can be split - plenty are scored to aid it

this is a right pondian phenomena - ask the docs to prescribe the drug which has the best cost / benefit analysis - in hospitla our formularly PPI of choice remains lansoprazole and the docs are encouraged to start anyone on lansoprazole as the PPI of first choice and only move to the more expensive ones if there is clinical need / the patient has problematic sided effects / adverse reactions

[nfahren05]

Originally Posted by FutureNurseLori

Teachers and books keep teaching students to assess the pt's financial situation as to whether or not they can afford the meds/treatments. Cool... what are we to tell them once we figure out they can't? I live in a suburb of a medium sized city. In the county of the city there are resources. If you make less than $15,000/anually there is help. What about those that make $15,001? What about the people in surrounding cities and rural areas without such programs? I can't find poop on the internet and I am fairly computer savy. What am I to tell these pt's that deserve to be helped? I have a friend of age 55 who cannot afford his blood pressure medication and makes barely enough to keep a one bedroom apt. I want to help him but I cannot find a way. Any suggestions?

For nurses working in acute care and skilled nursing facilities, the social worker and case manager are your best resource(s). Especially for patients who "fall between the cracks" of the system (i.e. income too high for most programs, but too low to be able to afford their care,) the social worker can help identify and access these resources. While it's important to know about these social resources, nurse educators sometimes forget that it's simply impossible for the bedside clinical nurse to be able to do everything: provide care, teaching the patient about his/her follow up care, reinforcing the importance of following his treatment plan, AND try to solve complex social issues after discharge. In the outpatient setting, more of the burden for finding supportive resources is placed on the office nurse, but (where the patient has health insurance,) it can be shared by the insurance case manager, along with utilizing the strategies listed above for minimizing medication treatment costs. In short, you can't fix this one yourself; it's a complex problem that requires the cooperation of multiple parties, not the least of which is the patient him/herself, adjusting financial priorities, permanently or temporarily, to meet changing health needs.