Customer Service IBM Customer Support 1 888 376

Customer Service • IBM Customer Support: 1 -888 -376 -0105 1

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Today’s Speaker Charles Eaton, M. D. , M. S. Director Rx. Assist

Making Medication Assistance Easier Using Rx. Assist and Learning Center The 4

Learning Objectives • Assist patients who are Uninsured or Underinsured • Identify Resources for Medication Assistance • Navigate through Rx. Assist and The Learning Center using Case Scenarios • Provide Tips and Handouts for Future use 5

The Challenge • Diversity of Patient Needs Uninsured Ø Underinsured Ø Medicare Part D Ø • Fragmentation of Resources • Difficulty for advocates/providers working with many patients in a timely manner 6

Rx. Assist • Rx. Assist for providers and patients • Quick searches for PAP availability • Selected resources for most common issues http: //www. rxassist. org 7

Rx. Assist Providers and Patients 8

Quick Search Advair 9

Rx. Assist Resources 10

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The Learning Center http: //learning. rxassist. org 12

Resource Library • Materials selected for their usefulness • Practical resources for providers • Handouts for patients 13

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Ask the Expert • Professionals representing expertise in assisting vulnerable populations • Rx. Assist staff decide which expert gets the question • Replies posted within one week of submission 15

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Discussion Forum • Ask questions • Post opinions • Recommend resources 17

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Rx. Connects • • Listserv for advocates and providers Moderated Messages posted daily Professionals across the safety net spectrum 19

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Website Issues • If you experience any problems with either the Rx. Assist website or the new Learning Center, please email us at info@rxassist. org

Uninsured #1 • • 45 -year-old, single man, recently unemployed No COBRA or healthcare insurance Income - $25, 000 3 medications Advair Ø Proventil Ø Celexa Ø 22

Uninsured #1 (cont’d) • Rx. Assist PAP database multiple drug search Advair Ø Proventil Ø Celexa Ø 23

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Uninsured #1 (cont’d) • The Learning Center Ø Resource Library Ø Lowering Medication Costs 27

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Uninsured #1 (cont’d) • Tips Encourage the patient to look into local sliding fee scale clinics should s/he need to find low cost health care; e. g. , FQHCs or free clinics Ø Find out if there is a “ 211 call center ” United Way in your state or county by going to: www. 211. org/ This program can be useful in helping individuals find a variety of assistance services Ø

Uninsured #2 • 67 year old woman, never worked • Not eligible for Medicare • PAP administrator assumes she is Medicare eligible • Multiple medications 30

Uninsured #2 (cont’d) • Rx. Assist PAP database multiple drug search • The Learning Center Ø Resource Library Ø Insurance & Health Care Access Ø Medication Management & Safety • Call Center 31

Uninsured #2 (cont’d) • Tips Familiarize yourself with programs such as Social Security and Medicaid so you can navigate their systems when necessary. Learn the procedure and timetable for getting “denial of benefits” letters from government agencies Ø Check Rx. Assist or The Learning Center’s state medication assistance chart to see if there are programs in your state that you might not know about Ø 36

Underinsured #1 • Married couple with insurance • Husband has met yearly prescription cap • Multiple medications and diabetic supplies 40

Underinsured #1 (cont’d) • Rx. Assist PAP database • Rx. Assist Provider Resources Ø Retail store pharmacies • The Learning Center Ø Diabetic supplies resource sheet 41

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Underinsured #1 (cont’d) • Tips When looking at retail pharmacies read the fine print; sometimes the cost represents a specific number of pills rather than the prescription as written by the doctor Ø Help patient project medication costs so that s/he can discuss with prescribing physician to identify cost saving measures Ø

Underinsured #2 • Patient with insurance • Can’t afford co-pays for medication • Patient has inflammatory bowel disease 45

Underinsured #2 (cont’d) • Rx. Assist PAP database • The Learning Center Health Access and Insurance Ø Lowering medication costs Ø Ø Co-pay assistance foundations 46

Underinsured #2 (cont’d) • Tips Ø Always check the disease association website to see if there any resources identified or local chapters that might provide assistance. For example, the one for IBS is: www. iamibs. org/

Part D Enrollee #1 • Chose lowest cost prescription drug plan • Can’t afford co-pays • Two of the drugs are Lipitor and Toprol XR 49

Part D Enrollee #1 (cont’d) • Rx. Assist PAP database • The Learning Center Ø Resource Library Ø Medicare 50

Part D Enrollee #1 (cont’d) • Tips Keep the PAP Eligibility Criteria & Medicare Part D chart from Rx. Assist handy. For example Astra. Zeneca, which makes Toprol XR, has a program to assist Part D enrollees titled the AZ & Me Prescription Savings Program for people with Medicare Part D Ø Check for companies such as Pfizer, which makes Lipitor, that have hardship exceptions Ø 52

Part D Enrollee #2 • In the doughnut hole • Can’t afford monthly costs • Multiple medications 55

Part D Enrollee #2 (cont’d) • The Learning Center Ø Ø Ask the Expert Post on the Forum 56

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Part D Enrollee #2 (cont’d) • Tips Ø See whether local senior centers, pharmacy schools or pharmacies have a “brown bag” service where patients bring in all medications for review by pharmacist. Pharmacist might be able to suggest therapeutic equivalents or other cost saving measures 59

? Questions / Discussion 60

Q&A Session 61

Rx. Assist Websites http: //www. rxassist. org http: //learning. rxassist. org 62