Editor’s Note: A chronic condition takes a heavy toll on patients’ health and their finances. In the latest installment of our “Patient Stories” series, learn how TailorMed Complete’s Greta Strom helped an arthritis patient navigate a sudden financial challenge after transitioning from commercial insurance to Medicare.

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Financial navigator: Greta Strom

Diagnosis: Rheumatoid arthritis

Type of healthcare organization: Health system

Medication: Entyvio (IV) and Rinvoq (oral)

Assistance program: Entyvio Patient Assistance Program (Takeda) and Rinvoq Patient Assistance Program (AbbVie)

Treatment cost without financial assistance: $4,900 per year for Entyvio / $2,000 per year for Rinvoq

Patient financial responsibility with assistance: $0

TailorMed financial navigator Greta Strom helped a patient with rheumatoid arthritis (RA) ease the financial burden of treatment. The patient relied on copay assistance for his IV and oral medications, Entyvio and Rinvoq. However, because he had recently transitioned from commercial insurance to Medicare, he was no longer able to use his copay cards. Following an infusion treatment near the end of 2024, he was hit with a large bill from his provider.

Before his next Entyvio infusion, Greta reached out and explained what his Medicare plan covered and why his out-of-pocket costs had increased. “The patient was upset, but I told him, ‘It’s OK. Don’t panic. I’ve got a plan,’” Greta recalled.

She began searching for financial assistance to lower the patient’s cost burden. Foundation grants were an option, but RA-specific funds typically have long waitlists. “The odds of a fund opening and getting the patient enrolled right away were slim,” Greta said.

So, she turned to the Entyvio Patient Assistance Program (PAP), sponsored by the pharmaceutical manufacturer Takeda. Greta quickly submitted the application and completed the enrollment process. “We got him approved for the program, so now, he’s receiving the medication at no cost and saving almost $5,000 per year,” Greta said.

Next, she enrolled him in a similar program for his oral medication, Rinvoq. “Some of these specialty medications are so expensive that one fill would cost a Medicare beneficiary $2,000, which is their annual out-of-pocket limit,” Greta explained. With AbbVie’s Rinvoq Patient Assistance Program, the patient receives his prescription for free–and it’s delivered straight to his home.

“If we hadn’t assisted him, the patient would have been stuck with a bill he couldn’t handle,” Greta explained. “He wouldn’t have continued with his infusions or started his oral treatment.”

For Greta, sharing the good news with a patient is the ultimate reward. “I always think, ‘What if this person were my mom or my grandpa?’ Whether they owe $500 or $8,000, it’s amazing to be able to call and say, ‘Remember that bill? I took care of it.’” 

Interested in partnering with our TailorMed Complete team to optimize financial assistance for your patients? Contact us to learn more.