Editor’s Note: Chronic conditions take a toll on patients, medically and financially. At TailorMed, we help patients across diagnoses find the resources they need to afford the care they deserve. In our latest patient story, learn how TailorMed Complete Financial Navigator Denise Chan went above and beyond to help a patient with severe asthma.
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Financial navigator: Denise Chan
Diagnosis: Asthma
Type of healthcare organization: Health system specialty pharmacy
Medication: Dupixent
Assistance program: The Patient Advocate Foundation-Copay Relief Program
Costs covered: $961 for a 30-day supply + ongoing expenses up to $2K for 1 year
TailorMed Financial Navigator Denise Chan helped a Medicare patient afford Dupixent, a medication used to manage severe asthma.
“With Medicare patients, even with the new $2,000 annual cap, affordability remains a real challenge,” Denise explained. “For folks with limited incomes, out-of-pocket costs can still be overwhelming.”
No foundation grants were open for asthma support, so Denise pursued a manufacturer free drug program. “After a few weeks, we received a fax indicating approval,” she recalled. “I was thrilled—he was finally going to get his medication.”
However, follow-up conversations revealed that additional steps were required for final approval, including a patient hardship call, proof of prior authorization, and confirmation of an M3P application.
“It can be a complex process,” Denise noted. “Financial navigators follow up every few days to make sure no step is missed. We do everything possible to help patients move forward.”
Then, an unexpected opportunity arose. “A Patient Advocate Foundation fund for asthma opened suddenly, and I was able to secure approval in just five minutes,” she said. The patient’s medication was paid for and dispensed the same day.
That assistance saved the patient nearly $1,000 and had an immediate impact. “The patient expressed immense gratitude and told me he could finally breathe again,” Denise shared. “Without this support, he would have had to go without treatment or rely on less effective alternatives.”
What’s more, the $2,000 grant helps cover ongoing expenses related to his diagnosis–such as infusions, inhalers, and insurance premiums–for a year.
Reflecting on the experience, Denise added, “I think I can speak for all financial navigators: We go the extra mile for our patients.”
Interested in partnering with our TailorMed Complete team to optimize financial assistance for your patients? Contact us to learn more.
