Sara Scherer's work is exceptional every day, but this week one specific area of patient care stood out. A young male patient with an extensive cardiac past was a great candidate for a very expensive cholesterol-lowering medication. He had been on the medication for a few months a few years past, prescribed from the cardiologist and then simply stopped the medication because it was no longer covered on his insurance. It has been priced at $542.31 for one single-use prefilled syringe. The patient would use one prefilled syringe every two weeks. This comes to $14,000 annually for every two weeks administration.
Sara spent close to one week pulling information from the patient's paper chart and electronic chart working on a prior authorization. The more medications a patient has tried and failed the better chance they have at getting an approval. In addition, comparative lab studies and office notes from the cardiologist were found and included. Sara was able to get the medication approved on his commercial insurance but at a high copay unaffordable for him.
Sara continued to strive to get this medication in the hands of the patient. I am happy to say she searched and was able to find a co-pay card that provided $5,500 per year towards his copays for this specific medication. As of today, the patient will pay five dollars per month for this medication. His risks of further cardiac events will decline thanks to the dedicated effort and advocacy for this patient by one nurse. I could present many examples of how Sara goes above and beyond for myself as a provider and most importantly for the patients. This is just one story.