The rates are already not very low at baseline - we need to understand why the remainder are not prescribed RASi or Flozins. Maybe it’s not just MD inertia/laziness/ignorance?
I can only speak as a PharmD, but I see a lot of situations where it was prescribed and pt couldn’t afford. This lives on for years as a reason for not being on, despite coverage changing throughout year (hitting deductible, etc) or between years (plan change). Med access needs routine assessment
Absolutely! But we are living and practicing in the U.S. where the system is against us ;) So we have to be creative. Medicare implemented a few big changes for med access this year that many are unaware of. Patients change plans year to year and enroll in low income subsidy..1/2
when they are fortunate to come across someone willing to help them enroll in these programs. Does that always track back to all the specialists wanting to prescribe expensive meds? In my experience, no. And that’s where clinical pharmacists can help solve med access issues and help physicians :)
So in my practice I can get an SGLT2i (per month) for:
💰$300-500 brand/generic from local pharmacies
💰$50 from online pharmacy owned by shark tank guy (Bexagliflozin)
💰 $5 if patient will see family med residents who are assoc with hospital (340B pricing)
🤪
Agreed. When they discussed why the patient nudges failed, it was because they had already discussed treatments with their docs and decided against initiation (for whatever reason) #NephJC
Comments
The rates are already not very low at baseline - we need to understand why the remainder are not prescribed RASi or Flozins. Maybe it’s not just MD inertia/laziness/ignorance?
#NephJC
Pt goes to pharmacy told it's ridiculous amt
Me, later: go try again, maybe you've hit your deductable
pt: yeah, no
can't blame 'em. Plus, what? do they only need it part of the year?
med access needs to be predictable and affordable
💰$300-500 brand/generic from local pharmacies
💰$50 from online pharmacy owned by shark tank guy (Bexagliflozin)
💰 $5 if patient will see family med residents who are assoc with hospital (340B pricing)
🤪
I think Nudge might work in India, where often baseline intervention levels are low...esp for RASi. Flozins are more popular. #Nephjc
But it’s a testable hypothesis
(Nudges are BS)
#NephJC