As we know, the most ineffective medication is the one needed but never taken. There are many reasons our patients don’t take prescription medicines, but a biggy is the cost. If a medicine is too expensive, the patient will not fill the prescription, therefore won’t take it. For example, when ordering an SGLT-2 and/or GLP-1, each can cost hundreds or more for a month’s prescription. Some are covered for both. Some are covered for one brand, but not the other.
A woman, 67 years of age, prediabetes, was traveling. She had left her GLP-1 at home. She found a local pharmacy, asked her prescriber to order it and her husband to pick it up. When her husband went to the pharmacy, the pharmacist told him the prescription would cost $875.00. He asked his wife if she wanted it. She (the patient) said, “Absolutely not at that price!” She then asked him to check if the pharmacy has her insurance information she gave him to give to the pharmacist. The answer was no. She then asked him to give it to her. Sure enough, the cost was $35.00. She told her husband, “Yes, please purchase.” He got it and she took her medication.
- When writing a prescription, ask the patient to ask the pharmacist to let patient know out-of-pocket cost before filling the prescription. Also, ask pharmacist to tell the patient.
- When patient gives insurance information, make sure the patient knows to give both sides of the card. The back side of the card will usually have the prescription coverage, which can be different from the name of the insurance.
- Even though you don’t think the medication will be covered, try anyway. You may be surprised. It may or may not be or it may be a different brand in the class. Try that!
If you have a “Diabetes Disaster Averted” story, please let us know! If we feature your Disaster Averted in our Diabetes Clinical Mastery Series e-newsletter, you will receive a $25 gift card. Please click here to submit a short summary of the incident, what you feel you learned from handling the incident, and your name and title. If you prefer to remain anonymous, please let us know, but still give us your name and address (so we can send you the gift card).
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