Sometimes little changes can make a huge difference.
Marcus is a big believer in this. He has a skin condition that runs in his family called plaque psoriasis. Though he’s been living with it all his life, some days feel more challenging than others. His condition causes rashes to appear on his skin, which can be painful and itchy, especially during a flare-up. Lately, he’s also been experiencing pain in his joints. Though he swims regularly to feel better, the pain and discomfort is taking a toll his overall health.
Over the years, Marcus has tried many different medications to control his outbreaks and manage any new symptoms. He’s always worked closely with his doctor in figuring out the best treatments to keep him feeling his best.
Recently, to assist with the joint pain Marcus has been feeling, his doctor suggested trying a new biologic therapy medication. This prescription, which came in the form of an injection, would be able to help with his skin flare-ups and ease the pain in his joints. Marcus was on board.
However, since this new medication was a bit cutting edge, the price tag wasn’t shy. Fortunately, Marcus has his health care benefits through Meritain Health®, including access to the CARE Program and Meritain Health Pharmacy Solutions. Help was on the way!
Because of the high dollar amount involved with the therapy Marcus was prescribed, a CARE specialist and pharmacist looked over his case. Together, they had some ideas for making some small changes—and saving Marcus some money!
In reviewing his medical history, they saw he was currently taking a similar type of medication. With this knowledge, it was recommended Marcus could skip the loading dose of his new medication. The loading dose is an initially higher dose of a prescription taken to achieve higher levels of the drug in the body. Doing this would also mean skipping the first four prescription fills—a move that would prevent Marcus from owing four specialty copays and would save his employer over $42,000! The proposed change was run by Marcus and his doctor—and everyone agreed this new plan made good sense from a clinical viewpoint and a cost-savings one, as well.
Additionally, the CARE team signed Marcus up for copay assistance. This extra step would save him another $2,940 for the year!
Marcus is blown away by the support he received in coming up with a treatment plan that worked for his condition—and his wallet. His new medication has been relieving his symptoms. And he’s thrilled to be hitting the pool again, feeling happier and getting back to enjoying life as usual!
This story is based on an actual member experience. Names and information have been changed to protect the member’s privacy.
This communication is intended for informational, promotional purposes only. The reference to previous outcomes made as a part of
this communication does not guarantee success or similar outcomes in any new or future cases, as the result of each case depends upon many factors, including but not limited to the facts of each case. Any actual savings will vary based upon numerous factors, and neither Meritain Health nor its affiliates guarantees any level of savings.