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Case Study: The Prescription Concierge Services

Background:

In the realm of employee healthcare benefits, few situations present as complex and morally challenging as the case of a dedicated, long-serving employee diagnosed with Hepatitis C. The treatment option, Sovaldi, stood as a beacon of hope, offering a potential cure. However, the drug came with an exorbitant price tag of $88,000 for a three-month course, not covered by the group health insurance plan.

The Problem:

The employee, John, had been with the company for over a decade. Diagnosed with Hepatitis C, he received a prescription for Sovaldi, a life-changing drug. Despite its high cure rate, it was excluded from the prescription formulary. With no financial means to cover the cost, John was faced with a dire situation – forego treatment or face significant financial hardship.

The Solution: Prescription Concierge

The company, recognizing the urgency of the situation and the dedication of their employee, decided to employ a Prescription Concierge service. This service specialized in navigating complex pharmaceutical landscapes to ensure patients received the treatments they needed.

Evaluation: The Prescription Concierge team evaluated John’s case, considering his health status, financial situation, and the medical necessity of Sovaldi.

Financial Assistance: They identified available financial assistance programs, including patient assistance programs, grants, and charitable organizations, to mitigate the financial burden.

Case Management: A dedicated case manager provided continuous support to John, coordinating appointments, tracking his progress, and addressing any concerns.

Results:

With the assistance of the Prescription Concierge service, John received Sovaldi. Here are the outcomes:

Health Improvement: John’s health improved significantly during the treatment, and he achieved a 100% cure to hepatitis C, enhancing his quality of life.

Financial Relief: By leveraging patient assistance programs and working with the physician’s office and the drug manufacture the prescription concierge service was able to not only get John the drug, his out-of-pocket expenses were dramatically reduced from $88,000 to 3 $25 co-pays totaling $75.00 for the treatment.

Employee Loyalty: The company’s commitment to John’s well-being bolstered employee morale and loyalty, showcasing their dedication to their team members’ health and security.

Conclusion:

The Prescription Concierge service provided an effective solution to a challenging healthcare problem for the business and the employee. It ensured John received life-saving treatment, alleviated the financial burden for the employee, Cured a significant medical condition improving the medical makeup for the group and prevented the high cost drug from hitting the group health insurance plan improving future renewal increases. Without saddling the employer with any cost, the prescription concierge service was a life saving solution to a difficult healthcare challenge for the employer and the employee.

Please contact Palmetto Insurance group to see how their Prescription Concierge Service can help your company.

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