The good news is there’s a medication that can help treat your newly diagnosed serious illness.
The bad news is it’s so expensive that you can’t buy it.
“That’s not a situation anyone should face,” says Lori Dowdy, manager of the Medication Access Team, run by the Johns Hopkins Department of Pharmacy and Johns Hopkins Home Care Group. Dowdy and her team work hard to make sure patients at The Johns Hopkins Hospital get the medicine they’re prescribed, even if their wallets are empty.
The Medication Access Team serves patients who are underinsured or have no insurance at all. According to the Centers for Disease Control and Prevention, in September 2016, 28 million Americans were uninsured, and millions more had insurance premiums, copays and deductibles they couldn’t afford.
The Medication Access Team was established in 2002. Since then, both the number of clinics and the number of patients the team serves have exploded.
“Oncology was the initial clinic our team supported with just one employee to assist with prior authorization and patient assistance,” says Dowdy. “Since then, as more clinics learned about this unique service, we have grown tremendously.”
Last year, the Medication Access Team helped nearly 2,100 patients across 45 clinics at The Johns Hopkins Hospital. As health care costs continue to rise, many people, whether insured or not, are unable to pay for the medicines prescribed by their doctors.
“Yesterday, we had a patient diagnosed with breast cancer,” says Dowdy. “Her insurance company told her that the out-of-pocket costs for treatment would be $12,000. A lot of our patients don’t have access to that kind of money.”
Dowdy and her team know the ins and outs of philanthropy, government grants and other medication access resources. They mine those sources every day to see what’s available for patients at Johns Hopkins who are unable to afford expensive medications. They found multiple sources to help the patient with breast cancer cover the exorbitant copay.
To get help from the Medication Access Team, patients have to apply for whatever medical benefits to which they might be entitled, as well as prove a certain level of income hardship.
“We see a lot of patients who are struggling to make ends meet,” Dowdy says. “But we’re also seeing growing numbers of working families who just don’t make enough money to cover some of these incredibly expensive medications.”
In addition to specialty medications to treat diseases such as cancer and hepatitis C, the Medication Access Team helps Johns Hopkins transplant patients and those with common chronic conditions such as diabetes and hypertension. The team works closely with the hospital’s interdisciplinary teams to find solutions.
“We’re all focused on the same thing,” Dowdy says. “We’re all doing our best to help our patients concentrate on getting better and not worry about how they’re going to pay for their treatment.”