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A senior patient came in with a new prescription for an Advair inhaler from her pulmonologist. When I told her the cost, she immediately began to cry. She had struggled with asthma symptoms for years and had tried Symbicort before, but it caused an increased heart rate and discomfort. This visit to the specialist was a long-awaited appointment—she had been waiting a year—and now the prescribed medication was priced over $200, well beyond what she could afford.
Recognizing her distress, I first faxed a special authorization request to the doctor’s office. Then I called her insurance provider because they had previously covered Symbicort for her. After reviewing her history, they confirmed prior use of Symbicort and provided a special intervention code for me to use. This code allowed the insurance to cover the cost of the Advair inhaler.
I contacted the patient to share the good news—that her medication was now fully covered. She was relieved and grateful and came back that very evening to pick up the inhaler.
Pharmacists routinely work behind the counter, sorting access issues for their patients. This is one of many examples.
Because of a pharmacist, something important happened.
