Help with rising medication costs

Sandra Garcia’s phone rings in her office for the second time in ten minutes. On the other end is yet another person who cannot afford next month’s supply of insulin, a lifesaving injectable for people living with diabetes. Rising prescription drug costs have spurred alarm in Garcia’s clientele, but she confidently assures she will do all she can to help.

As program coordinator of the Medication Assistance Program of the Texas A&M Health Science Center Coastal Bend Health Education Center (CBHEC), Garcia has assisted hundreds of uninsured and underinsured South Texas residents with obtaining their prescription medications – including insulin – at a low or no cost, despite rising prices caused by a number of recent changes in the pharmaceutical industry.

“We have seen more and more clients coming to us needing assistance with insulin,” she said. “Most of them don’t have insurance, but even some insurance does not cover insulin, and we can help those individuals, too.”

People who are considered underinsured have health benefits that do not adequately cover all of their medical expenses. For these people, some prescriptions may be covered while others are not, or they might have high out-of-pocket expenses. Unfortunately, many people don’t discover they are underinsured until an emergency occurs or they are faced with a serious illness, like diabetes, that requires prescriptions that are not covered by their insurance.

The cost for insulin without insurance coverage is anywhere from $200 to $500 per month and higher, depending on the amount an individual needs to keep his or her diabetes under control. This can be devastating for those whose income lies below federal poverty thresholds, but, according to the American Diabetes Association, poverty and type 2 diabetes are tightly linked.

More than 17 percent of Texas residents live below the poverty level (compared to 14.5 percent nationwide). At 38.3 percent, Brooks County, Texas, is the poorest county within CBHEC’s service area and third highest in the state for poverty (Willacy County is first with 40 percent, followed by Starr at 39.2 percent). On average, the Medication Assistance Program saves each of its clients in Brooks County about $2,500 a year on prescriptions. Since 2010, this has added up to $4.3 million in prescription cost savings for residents of Brooks County, not including the nearly $700,000 in savings so far this year. In total, 5,276 people across the program’s 20-county service area have saved more than $14.6 million in prescription costs since 2010.

The program’s staff is able to lower their clients’ prescription costs by assisting them with filling out lengthy and often complex applications that offer a limited supply of free or low-cost medications through pharmaceutical companies’ patient assistance programs. They also connect clients with a number of other resources available through retail pharmacies and indigent programs. The resources and expertise of CBHEC’s Medication Assistance Program staff allow them to track down the lowest possible cost for medications that treat not only diabetes, but also cardiovascular disease, respiratory conditions, mental health, chronic pain, and nearly every other disease state.

“Some of our clients have up to fifteen different medications and have to alternate them on a monthly basis because they can’t afford to pay for all of them at once, but we are able to find some of their medications for as low as $4,” said Eslanda Trevino, a community health worker with CBHEC’s Medication Assistance Program in Falfurrias, Texas.

And for those who need insulin? Garcia says they can help people get it at absolutely no cost to them.

The Medication Assistance Program has offices in Corpus Christi, Falfurrias, Kingsville, Victoria, and Cuero, Texas to assist low-income residents in and around these areas. For more information or to schedule an appointment, call toll free at 1-866-524-1408.