Saving One Nurse Over $18,000 in Rx Costs

An HIV diagnosis is a heart-shattering event, but for one nurse practitioner based in Baltimore, the crushing weight of her monthly drug bill was equally disheartening.

Our member was taking Triumeq 600 mg tablets once a day and had a monthly cost of $3,000. She was also taking two additional medications for other ailments.

When her company started offering HealthJoy at the start of 2018, JOY, our virtual assistant, asked about her medication. HealthJoy performed an Rx Savings review for all three medications, with a large focus on saving her money on Triumeq. The drug is only available at specialty pharmacies. Her company insurance plan was covering $1,500 of the monthly costs, she was required to pay the remaining $1,500.

We first recommended our member to sign up for a 90-day mail order prescription from the doctor, then worked with the drug manufacturer to secure a manufacturer saving coupon that she qualified for. This reduced her out-of-pocket costs to zero. The coupon had an annual limit of $7,500 in savings but she hit her deductible before reaching that limit. We worked with Castia Rx to have the new prescription filled and delivered overnight for the next day.

A New HealthJoy Advocate

We also had some recommendations for her other prescriptions — a cholesterol-lowering statin drug and a blood thinner. We had her move these prescriptions to Walmart and switched one of the medications to a generic. This lowered her out of pocket cost from $74 to $8, as the drugs now qualified under the Walmart $4 prescription drug program.

“Compared to the savings for Triumeq this might not seem like much, but it’s another $800 annually so for me it’s huge. I go to Walmart at least once a month anyway, so this was just a one time hassle to move over.”