A Bitter Pill to Swallow: Many Americans Can’t Afford Their Medicine

For the first time in decades, Americans are actually spending less on their medication That’s according to a recent study by IMS Institute for Healthcare Informatics which found  the total spending on medicines fell 3.5 percent last year –from $329.2 billion in 2011 to $325.8 billion in 2012. The study attributes much of it to an encouraging trend: the declining use of brand-name drugs and the greater availability of less expensive generics. But it’s not all good news. The study’s authors say that the decrease spending on medications was driven also by consumers cutting back on health care overall – and going to the doctor less and less, because they can’t afford to.

 

06.12.13.2Problems paying for medical bills and medications remain the most pressing financial problem Americans face, even more so than problems with making their mortgage payments or paying other big household bills. And, saving money on health costs frequently means cutting corners elsewhere—both findings according to an annual national telephone poll by Consumer Reports Best Buy Drugs a free public education project that provides free guidance on the safety, effectiveness, and cost of drugs. More than half of survey respondents who take at least one prescription drug said they had to take steps to reduce other household expenses or change how they manage their finances to pay for their medication. Those steps included spending less on groceries, relying more on credit cards, and postponing paying other bills. And many took some potentially dangerous measures, such as putting off a doctor’s visit, declining a medical test, delaying a medical procedure, failing to fill a prescription, or cutting pills in half without the OK from their doctor or pharmacist.

 
If you’re having trouble affording your medications, bring it up with your doctor. Consumer Reports’ research shows that only 6 percent of patients found out the cost of a prescription drug during a doctor visit, while two-thirds first learned how much their drug would cost when picking up their medicine at the pharmacy counter. One way you can lower your out-of-pocket drug costs is by asking your doctor to prescribe a generic version of the drug you’re taking. Generic drugs are just as effective and safe as their pricier brand name counterparts. The Food and Drug Administration requires that over-the-counter and prescription generic drugs have exactly the same active ingredients in the same strength as the brands they copy.



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Best Buy Drugs’ experts also recommend shopping around, since prices for the same drug can vary from pharmacy to pharmacy. For example, a one-month supply of generic Lexapro and generic Lipitor cost about $100 less at Costco than at CVS or Rite-Aid. Also, consider getting a 90-day refill of your drug, rather than just a month’s supply, take advantage of discount generic-drug programs, and when you pick up your prescription, tell the pharmacist you want the lowest possible price, whether you have insurance or not. The retail prices can sometimes be lower for certain drugs than many insurance copays. Take the generic Lexapo example: It cost an average of $7 at Costco—which could be less than your insurance co-pay, which his often about $10 for generic drugs. Find out which pharmacies have the lowest out-of-pocket drug costs.

 

– Ginger Skinner

 

Ginger Skinner is a writer for Consumer Reports Best Buy Drugs, a public education project dedicated to helping you talk to your doctor about prescription drugs, and helping you find the most effective and safest drugs for the best price. Learn more about how to save on your medications.

Helpful Online Resources

For today’s blog post we would like to share with our readers some fantastic online healthcare resources. There are many websites out there dedicated to healthcare, some great and some not-so-great. Here are four resources that the staff at NeedyMeds think you will find helpful.

 

Together Rx Access – Together Rx Access provides a number of different resources for patients and healthcare professionals alike. They have partnered with a number of the nation’s leading pharmaceutical companies to offer a free drug discount card program for those without prescription drug coverage. Furthermore, their website has extensive articles on the Affordable Care Act and healthcare reform as well as a “Better Health” section with articles and insights on how to maintain a healthy lifestyle. They also have an entire “Resources For Professionals” section with information for patient advocates and other healthcare professionals.420707_10150608413178932_1637613913_n

 

Consumer Reports Best Buy Drugs – Consumer Reports is a non-profit organization dedicated to working for a “fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves.” Their Best Buy Drugs site takes this mission statement and focuses on prescription medications. This includes in-depth details of the medications, their recommendations, and comparisons with other medications. NeedyMeds recently partnered with Consumer Reports Best Buy Drugs, and we now display their medication information on our Patient Assistance Program listings.

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PsychCentral – PsychCentral is a website dedicated to mental health. Their site is run entirely by mental health professionals. They cover every mental health diagnosis with extensive discussion and insights into symptoms, causes, support groups and treatment options. They also have dozens of very informative and regularly updated blogs covering a wide range of topics. If you or someone you know has a question about mental health, PsychCentral should be the first place to turn on the web. PsychCentral

 

Treatment Diaries – Treatment Diaries is a new type of online community where people are able to share their experiences with different diseases and disorders anonymously. People are able to connect with one another and open up about their treatment or the treatment of a loved one. Finding someone to talk with about your illness can be difficult and oftentimes intimidating. Treatment Diaries makes it much easier to find someone in a similar situation, and the ability to remain anonymous creates a safe environment to share your story.

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Paying for Home Modifications

When caring for a loved one, many families look for financial assistance to help specifically with the cost of home care services. While there are programs that provide assistance in this area, many families fail to consider other forms of assistance that can make their loved one’s residence more accessible and safer. A safe and accessible home can actually reduce the need for home care services as well as prevent unexpected increases in home care services costs by helping to avoid injuries. This articles aims to help families better understand their financial assistance options for making home modifications for elderly or disabled individuals.

When thinking about financial assistance, it helps to first identify the different components of a home modification project. Most projects have costs associated with the materials and separate costs for labor. For example, one purchases bathroom grab bars from a hardware vendor and then pays a home contractor to install them securely. This separation is important because oftentimes assistance for these two parts comes from two entirely different programs.

hammerFinding financial help for the hardware portion of a project is easier when one recognizes the phrase

“assistive technology” and realizes that it is nearly synonymous with “home medical equipment.” The official definition is below and it is broad enough where any physical item for a home modification can be classified as assistive technology, and this opens up a world of assistance opportunities.

Assistive technology is “…any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.”

Possible sources of funding for assistive technology include Medicare, Medicaid, the Veterans Administration, non-profit organizations and state-based nursing home diversion programs. NeedyMeds has a database that includes assistive technology and home modification services within the Diagnosis-Based Assistance database. The good news about Medicare is that it will cover the cost of some supplies for home modifications but the bad news is that their limited coverage is usually for items that are medical in nature. A table of which items Medicare will and will not pay for is available here. Medicaid, however, is much more generous. Almost every state has a Medicaid waiver for home- and community-based services which help individuals avoid nursing home placement by providing support for them to live independently. As such, these Medicaid waivers will pay for home modification materials to support independent living.

Within the VA, there are several sources of assistance. VA Medical Care, like Medicare, may pay. There are also Veterans Directed Home and Community Based Services (VD-HCBS) that are, in loose terms, similar to Medicaid waivers. Finally the VA offers several types of grants that can be used to help veterans with material costs; these include SHA, SAH and most broadly the HISA grants.

Nursing home diversion programs are like Medicaid waivers in that they provide supports including help for assistive technology to allow individuals to remain living at home. They are intended to assist lower income individuals that do not qualify for Medicaid. The challenge lies in identifying these programs as they have different names in each state and they are not available uniformly across all 50 states.

Many of these same options provide assistance for the labor portion of a home modification. Unfortunately, Medicare is not among them. Medicaid waivers, VD-HCBS and the aforementioned SAH, SHA and HISA grants can all be used to pay home contractors as well as the nursing home diversion programs. In addition to these options, the Department of Housing and Urban Development (HUD) offers home improvement loans and the USDA offers Rural Repair and Rehabilitation Grants.

To limit one’s view of assistance to only financial assistance is to discount one’s best option, which is to find free labor. Many organizations provide free labor to assist in home modifications. Most notably is a national program called Rebuilding Together. On a local level, one should consider contacting churches, high schools, fraternities, unions, independent living centers, Rotary, Lions and other clubs and neighborhood associations. Even if these institutions do not have an established volunteer home modification program, many will take on the project on a one-off basis.

paying_for_sr_care_logoThe organization PayingForSeniorCare.com maintains a searchable database of financial assistance programs that can help with the cost of home modifications. They have also authored articles specifically about paying for motorized wheelchairs and paying for bathroom safety modifications.

Alex Guerrero is the Director of Operations for Payingforseniorcare.com, an organization whose mission it is to help families find the means to pay for long-term care of their loved ones.

Heart Health Risks in Men – Paying Attention in Your 20’s

According to the CDC, heart disease is the leading cause of death among Americans with 597,689 deaths attributed to it in 2010. Heart disease kills one in four men in the United States. For many older men this is not news, and young men are becoming more aware of the facts every day – yet very few act upon this information. More and more doctors are saying that heart disease can be prevented, but it is up to us to act before it is too late.

 

So what can we do to prevent heart disease? First off, stop smoking. A study from the Coronary Artery Risk Development in Young Adults (CARDIA) shows that smoking 10 cigarettes a day increases the likelihood of coronary artery disease by 50%. In patients under 40 years old, 80% of those who suffered a heart attack were smokers. So besides the fact that smoking in and of itself is a nasty habit (actually an addiction), it also greatly contributes to heart disease. Even secondhand smoke is being looked at as a factor. “At all ages, smoking is the most powerful single contributor to atherosclerosis, and research continues to add to the evidence that exposure to secondhand smoke is also an important culprit.”

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Another major factor in heart disease is low-density lipoprotein, also known as LDL or “bad cholesterol.” According to the same CARDIA study as above, each 30 mg/dL rise in LDL cholesterol increased risk by 50%. But what is LDL cholesterol and why is it bad? “When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible.” Foods that are high in LDL cholesterol include “butter, lard, fast foods, junk foods, high-fat meats, cream, liver, and hidden trans fats in baked goods and processed foods such as crackers.” So next time you are about to stop at the drive-through window, try and consider a healthier option.

 

The two other factors that are most likely to increase your risk of heart problems are blood pressure and blood sugar. “Each 10 mm Hg rise in systolic blood pressure increased risk by 30%; and each 15 mg/dL rise in blood sugar levels increased risk by 20%” (Harvard). While it is best to speak with your doctor about controlling your blood pressure, some basic tips to keep it under control include regular exercise and again, not smoking. Your blood sugar levels are influenced by a variety of things, the most obvious being diet and exercise.

 

Taking care of your heart is vital to maintaining good overall health. Being proactive about heart health while you are young can have a big impact as many of the causes of heart problems come from decisions you make when you are younger – not smoking, having a balanced diet, and regular exercise along with regular doctor visits will keep your heart healthy.

Streamlined Access to HIV/AIDS Assistance Programs

An estimated 56,000 persons in the United States become infected with HIV every year. Of the 1.1 million persons living with HIV in the United States, approximately 250,000 are not aware of their infection and their risk for transmitting HIV to others. Of those who are unaware, many are diagnosed late in the course of their infection, after a prolonged asymptomatic period during which further transmission may have occurred. Persons who are diagnosed late in their infection miss a valuable opportunity to start HIV care and are at greater risk for AIDS-related complications (than those diagnosed earlier). Therefore, it should be a priority to identify HIV-infected persons and actively link the newly diagnosed to medical care, prevention and retention programs in the HIV care system. However, depending on the availability of publicly funded programs on a state by state basis, HIV medications are often not readily accessible to those who are uninsured.

Of the 1.1 million people living with HIV/AIDS in the United States, approximately 25% are uninsured and even more than that will experience a gap in health coverage at some point during a benefit year.  Those who do not have health coverage or are experiencing a gap in coverage, rely on the pharmaceutical companies’ patient assistance programs as a safety net.  It is estimated that there are 20,000 – 30,000 patients currently accessing HIV PAPs throughout the United States.  While the manufacturers of HIV medications all offer patient assistance programs, industry and public health officials have long recognized the need for a common portal to access these programs.  The HarborPath common portal eliminates burdensome paperwork and ensures that medications are dispensed and delivered to patients in a coordinated and efficient manner.

 

HarborPath is a not for profit 501(c)(3) corporation located in Columbia, South Carolina that was launched in July 2012.  The organization is a cooperative effort supported by the Clinton Health Access Initiative (CHAI), the National Alliance of State and Territorial AIDS Directors (NASTAD) and pharmaceutical companies to improve access to HIV medications through patient assistance programs (PAP).  HarborPath’s mission Screen Shot 2013-05-16 at 10.13.40 AMis to streamline the PAP application process for people living with HIV/AIDS who are uninsured and have no other access to HIV medications.  HarborPath operates an electronic, on-line common portal where case managers and patient advocates can go to access HIV medications and process HIV patient assistance program applications.  A common portal eliminates burdensome, duplicative paperwork normally required to submit individual PAP applications and ensures that medications are dispensed and delivered to patients in a coordinated and efficient manner.

The initial release of the HarborPath single electronic portal for access to HIV PAPs is the product of input from a variety of stakeholders including HIV case managers, public health department staff, pharmaceutical companies, NASTAD and CHAI.  The system was developed in alignment with the business rules of the pharmaceutical companies’ programs to ensure that all of the necessary data is captured regardless of which drug is requested.  The overall portal design provides case managers with access to all HIV PAP applications, allows for one time data entry for case managers and reduces the time spent processing PAP applications.

HarborPath currently receives donated HIV medications from Gilead, Merck and ViiV and is able to dispense their medications through the HarborPath contract pharmacy.  Negotiations with additional pharmaceutical companies that manufacture antiretrovirals are in progress towards the HarborPath vision of a full complement of HIV medications available for dispensing through the HarborPath contract pharmacy.  In addition to the full array of antiretrovirals, HarborPath is working with pharmaceutical companies to supply Hepatitis C medications for both mono-infected and co-infected patients.

The HarborPath portal has been launched as a pilot in multiple HIV clinics, AIDS Service Organizations (ASOs) and Community Based Organizations (CBOs) in multiple states that were identified as areas of high need including Alabama, Florida, Georgia, South Carolina, Texas, Washington and Washington, D.C.  HarborPath continues to expand to additional sites in 2013.

Given the collaborative nature of the development of the HarborPath common HIV PAP portal and the long-standing need for streamlined access to donated antiretrovirals, HarborPath is poised to fill the needs of those who rely on HIV PAPs for their medications in 2013 and beyond.

 

 

 

Noreen O’Donnell, MSW

Noreen O'Donnel, MSW

Noreen O’Donnel, MSW

Noreen O’Donnell is the Director of Program Services for HarborPath, a new non-profit HIV medications assistance program that is currently piloting its program in Alabama, Florida, Georgia, South Carolina, Texas, Washington and Washington, D.C. As the Director of Program Services Noreen oversees program development and provides technical assistance to HarborPath portal sites.

Prior to coming to HarborPath in September 2012, Noreen was the Ryan White Program Manager for the STD/HIV Division of the South Carolina Department of Health and Environmental Control (DHEC) in Columbia, South Carolina. In that role Noreen oversaw the administration of all of the HIV care and support services for DHEC including Ryan White Part B, ADAP Direct Dispensing, ADAP Insurance Program, Ryan White Part D and the Housing Opportunities for Persons with AIDS program.

Noreen has been working in the field of HIV/AIDS since 2002. She has a Bachelors degree from The Ohio State University, a Masters degree from the University of South Carolina and served as a Peace Corps Volunteer in Togo, West Africa.