Living with a condition like cancer, hepatitis C, HIV, bleeding disorders, or multiple sclerosis requires specialized treatment, medication, and support – to help patients live longer and more fulfilling lives despite their disease.
Enter specialty pharmacy Accredo, which serves people living with complex and rare diseases through personalized care and services. In addition to dispensing critical life-sustaining medications, Accredo helps patients with navigating insurance coverage, medication adherence, and more, all while maintaining an open line of communication with health care providers.
Accredo specialty pharmacists, nurses, and passionate customer advocates work hard to educate patients about their medications and provide them with the resources they need to manage their condition. Below, we shine the spotlight on just a few of our dedicated Accredo team members, and how they go above and beyond for our customers every single day.
1. Helping a Hemophilia Patient With Medication Adherence
Whether a patient's issue takes minutes or months to resolve, Maira Barkauskas-Guild, a customer relations specialist at Accredo, is determined to find a solution.
Barkauskas-Guild works with patients who have questions about their treatment or face obstacles that could prevent them from taking their medications as directed. She is frequently able to help patients during a quick phone call, but she also is adept at providing long-term support when needed.
More than a year ago, a hemophilia treatment center referred a patient to Accredo who was being hospitalized frequently. People with hemophilia are treated with factor, an injected product that helps their blood clot. When Barkauskas-Guild reached out to the patient, he explained his insurance covered 80% of the cost of factor. The remaining 20% was too much for his budget, so he went without factor. As a result, he frequently ended up in the emergency room for treatment.
“This is exactly why we want patients to be adherent to their treatments,” Barkauskas-Guild said. “Following their treatment regimens not only keeps them as healthy as possible, but it helps prevent trips to the hospital. This patient’s out-of-pocket costs kept him from proactively treating his hemophilia. But each hospital stay had costly consequences, including missing work – which meant a smaller paycheck.”
Barkauskas-Guild investigated grants that would help cover his treatment and found several that would pay his portion of the costs. However, she couldn’t apply for the grants on his behalf – the patient needed to apply for them himself. He works many hours, so he is difficult to contact. Much of Barkauskas-Guild’s outreach to him was through texts. Her texts and their conversations focused on why it was important to prevent bleeds, and she emphasized that if he secured grants to help pay for his treatments, he would be much healthier.
After almost 12 months of Barkauskas-Guild checking in with him and keeping the treatment center’s physician informed, the patient was approved and began receiving shipments of factor. He is now able to remain adherent, which will help him avoid bleeds and stay as healthy as possible.
“This outcome also strengthened our relationship with the treatment center’s staff,” Barkauskas-Guild said. “They know we are champions for patients.”
2. Ensuring a 9 Year Old With Pulmonary Arterial Hypertension (PAH) and Down Syndrome Gets the Care He Needs After a Natural Disaster
When a 9-year-old boy with pulmonary arterial hypertension (PAH) and Down syndrome – who is continuously infused with intravenous and oral PAH medications – was referred to Accredo, one of our specialty-trained PAH pharmacists was engaged to ensure that the patient did not experience a gap in care due to delivery issues caused by a hurricane in his area.
During the consultation, pharmacist Joe Kostuch determined that the family was facing challenges that may ultimately impact the patient’s overall health and well-being and so he engaged specialty-trained PAH social worker Bridget Scotino to assist the patient’s grandmother.
The family was struggling to make ends meet after the storm. They needed a new roof, had a slew of unpaid medical bills, and the family car was impacted as a result of the hurricane as well, making access to care a challenge.
Scotino was committed to helping this boy and his family. For example, she encouraged the patient’s caregiver to appeal a FEMA application for assistance, resulting in coverage for the damaged roof from the storm. She also assisted in securing temporary housing for the family while repairs were made and got them financial assistance to help with the unpaid medical bills that had been stacking up.
And to ensure that the boy can get the care that he needs, Scotino arranged for the purchase of new car tires to enable safe travel to physician appointments.
The boy’s grandmother and physician nurse coordinator say that they truly appreciate Scotino’s assistance and support through all of this family’s challenges as a result of the devastation caused by the hurricane.
3. Getting Coverage for a Baby With Spinal Muscular Atrophy
Zolgensma is a gene therapy that treats spinal muscular atrophy (SMA) with a single $2 million dose. Without it, infants born with the condition may have a very short life span. The Accredo team is dedicated to helping families get approval for this therapy, no matter what health plan or specialty pharmacy they use.
When Barbara Mac Nish, a senior account executive for Accredo, opened Facebook one Saturday morning, she expected to see the usual updates and ads and videos. “What I found was a GoFundMe request to save a little girl’s life.”
As soon as Mac Nish opened the request, she knew exactly what drug it was for: Zolgensma. Babies with SMA are diagnosed shortly after birth, and those who aren’t treated have a very short life span. These babies eventually need specialized wheelchairs and are on ventilators around the clock. Other drugs can slow the progression of the disease, but only Zolgensma was being marketed as a potential cure.
The mother had been fighting to get approval from her health plan, and she was running out of time. Mac Nish immediately sent a Facebook message to the mother.
“I told her who I was and that I worked for Accredo, one of only two pharmacies in the United States that can dispense Zolgensma,” Mac Nish said. “I explained we have a whole team dedicated to trying to get coverage for this medication, and asked if I could try to help. The family was not covered by Cigna, but that didn’t matter. We have the expertise to help people get access to this drug, and we are always ready to do what we can.”
The mother was grateful that Mac Nish had reached out, and the account executive got in touch with the Zolgensma team. As they began their efforts to get the drug covered for the patient, they also suggested actions the mother could take. She followed every suggestion and was able to get her insurance company to approve Zolgensma.
“Today, this little girl is thriving,” said Mac Nish. “She no longer needs to be on a ventilator and has gained motor control of her hands, arms, feet, and neck. Without Zolgensma, she probably would not be alive today.”
The mother and Mac Nish have developed a friendship, and they stay in close contact. She is now an advocate for other patients, helping them gain access to Zolgensma as well.
As it turned out, Accredo did not end up dispensing the drug. The plan ended up getting it from the other pharmacy, but that’s not important. “We know that there’s no guarantee that we will get the prescription, but we help without hesitation, Mac Nish said. “We are dedicated to trying to get these babies covered.”
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