3 Today’s Speaker Robert McEwan Chief Executive Officer MEDBANK of Maryland, Inc.
4 Learning Objectives How to create a set plan for approaching your clients specific circumstances. The value of discount cards and how your clients can maximize them at their local pharmacy. How discount cards can help your clients with prescription drug coverage achieve additional cost savings.
5 Goals of Our Advocacy 1.To help every patient in some way and reward them for making the call, asking for help – it’s more difficult for some to do that than you realize. 2.To “triage” the patient for all available levels of assistance. 3.To try to address any and all the medications a patient is taking, not just those that are available for “free.”
6 Helping ‘Every’ Patient Has Always Been Intentional MEDBANK started with the recognition that disasters with our patients are avoidable; but asking for help takes a lot - the case that changed everything. We began with a plan to make it safe for a patient to ask and a determination to keep going back once a patient did ask until they accepted help or at the very least, we could send them something helpful. We began concentrating on PAP and knew that the weakness was that all the generics were uncovered. We ‘evolved’ over 10 years to do more and be more comprehensive.
7 Triage the Patient Tell them if you think they are eligible for an government entitlement programs, PAP, and/or a discount. General guidance for advocates: when to look at discount cards. General guidance for advocates: what to look for in a discount card. Recommending cards; using multiple cards?
8 Add Value If you think a patient is eligible for a PAP but they are “too private” or “too proud” to send in a lot of private information – tell them about TogetherRX Access. The call is free and only requires the patient to recite their information over the phone. Historic generic programs with income requirements Most discount cards cannot “beat” the $4 drugs at WalMart, Target or other retail store. However, if it’s not on their formulary, you can offer the next best thing – most generics for $10 or less!
9 Discount Cards Can be Confusing: All Discounts are not Created Equal! Many types: city cards, county cards, state cards, grocery store cards and the new RxAssist Card. Many cards state discount on the card – if they have a Web site and pricing tool – check it out and compare. Always advise the patient to pay the lowest price: example – many pharmacies will beat the patient’s discount voluntarily upon seeing the discount price. I repeat; always pay the lowest price!
10 Try to Address as Many Needs as You Can Explain to the patient that the process for a government entitlement, a PAP or other things you will pursue will all take time but that with the discount card they can get started today. Give them an idea of the expected savings: 40% off AWP for Generics = 50-70% off retail depending on the store. 15% off Brand AWP = 25-45% off retail for the same reason. Tell the patient how to get cards from the web.
11 Position the Value of the Card to “Do Something” RIGHT AWAY! Using the ‘look-up/pricing tool’ patients can enter their zip code and how many surrounding miles of pharmacies they want to include.
15 Position the Value of the Card to “Do Something” RIGHT AWAY! After the list of pharmacies come up; enter a drug name direct from the labels or prescription, the dose prescribed and the number of days they typically get 30, 90, etc. All of this can happen over the phone! Add every drug the same way and the list that comes up will show the price they will pay in each of the pharmacies for each of the meds. The ‘look-up/pricing tool’ will also list price of generic medications when available – prices and availability are all that matter immediately, even though subsequent applications may be for the original brand.
18 “Do Something” RIGHT AWAY! Walk the patient through bringing up their card, printing it out and explain how to use it. When the patient has no prescription coverage, the discount card can do a lot – covers most of the PDR! Instead of insurance co-pay – with generics it beats many co-pays; tell the pharmacist that you want to use your discount card instead of insurance today. Special circumstances – Medicare Part D…
20 Favorite Pharmacies…. Suppose your favorite pharmacy doesn’t accept the card based on the ‘tool’ look-up? Ask the pharmacy to call the number on back of card for information on joining the program so you can keep bringing your business to them! They want your business! Street pharmacies, hospital pharmacies, literally any pharmacy can get on the program and accept the card.
21 Bottom Line…. Bring your heart out to every patient; treat them as if they are the first you ever talked to and are like a member of your own family. Remember that asking for help can be difficult; they may have to surrender private financial, heath care and family information in the process of asking for help – sometimes it takes a lot of coaxing. The easiest thing a sick person can do is Quit – don’t let them.
22 Everybody Can Benefit The ideal discount card: 1.No income requirements; your family or employees could use it (it beat our company co-pays!) 2.No enrollment – no private information requested at all! 3.No fee! 4.Good discounts; at least 40% for generics or 15% for brand 5.You can’t lose the card – they are all the same and can be downloaded at any computer and printed out.