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Dealing With Cancer Financial Worries Due to Coronavirus

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Published on April 28, 2020

Key Takeaways

Where can cancer patients find financial relief during the coronavirus pandemic? Dan Sherman and Ayesha Azam share guidance for navigating the complex financial issues surrounding cancer and COVID-19. 

They discuss some financial aid programs available for medical and non-medical expenses, and how drug companies are responding to the outbreak. Watch to learn more about resources and assistance offered to help support patients. 

This program is sponsored by Incyte, Janssen and Pharmacyclics. These organizations have no editorial control, and Patient Power is solely responsible for program content.

[Due to extreme load on our website and Zoom platform, viewers may experience a time delay between the audio and video of the interview - please note the transcript can be read below.]

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Transcript | Dealing With Cancer Financial Worries Due to Coronavirus

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Recorded on April 24, 2020

Andrew Schorr:
Welcome to this live Patient Power webinar. I'm Andrew Schorr. Special thanks to our sponsors for this program as we cover financial and access issues related to cancer medicines. They are Pharmacyclics, Janssen and Incyte Corporation. Thank you very much.
 
Joining us from Maryland is Ayesha Azam, and she is the vice president of medical affairs at the Patient Access Network Foundation. Ayesha, welcome. Thank you for being with us. 

Ayesha Azam:
Thank you for having me.

Andrew Schorr:
Thank you. Also, our friend who's been with us previously on discussions related to financial issues for cancer patients, that's Dan Sherman who joins us from his day job at Mercy Health—let me get it right, Mercy Health—you tell me, Dan.

Dan Sherman:
Mercy Health Saint Mary's in Grand Rapids, Michigan.


Andrew Schorr:
Grand Rapids, Michigan. Thank you for being with us once again. Now, Dan, you are an oncology financial navigator and help others around the country at hospitals and clinics go to bat for patients, right?

Dan Sherman:
Correct.

Andrew Schorr:

In this time when there are some very effective cancer medicines, but they're not cheap.

Dan Sherman:
Right.

Andrew Schorr:
Okay. Ayesha, tell us a little bit about the Patient Access Network. What do you do with your foundation?

Ayesha Azam:
I'd be happy to. The Patient Access Network Foundation, also known as PAN for short, has been around since 2004. And what we do is we provide financial assistance to people in need who may have life-threatening or chronic diseases and have a hard time paying for their prescription medications. What folks are able to do is they're able to come to us, and we're fortunate to be able to help them by providing them with a grant that they can use to put towards the out-of-pocket costs.

Andrew Schorr:
Okay. Now, Dan, so you at the hospital level, PAN might be one of the organizations that you call upon, right? Then there are others, for me with leukemia, could be The Leukemia & Lymphoma Society. There are other groups that provide assistance. You navigate all that for us, right?

Dan Sherman:
Correct. It gets complicated pretty quickly, because there are multiple different types of programs out there. There are foundations, but then also pharmaceutical companies will help patients directly as well if they have commercial insurance. Sometimes we're navigating 50 to 60 different types of programs for patients. It's the role of the financial navigator to help steer that for the patient and get them into the appropriate programs.

Andrew Schorr:
Okay. We're doing this at a time when people who thought they had insurance because of their employment status are finding out that maybe that's not continuing. They may be worried about paying the rent, having money for food. Unfortunately, we have very high and increasing unemployment now in the U.S. related to the COVID-19 situation and worries about coronavirus. Dan, let's talk about that. I'm sure you are a busy guy always, but people have a lot of anxiety and some people who never needed your services before. Let's talk about accessing a financial navigator and what you try to do now.

Dan Sherman:
Maybe one point to make here is that, and it's sad to have to say this, but a lot of Americans are experiencing what it's like to be a cancer patient at this point. Because when you're diagnosed with a major illness like cancer, they often run into situations where there's a decrease of income coming into the home, and then they are fearful of losing their insurance. In today's environment, a lot of people are experiencing exactly the same thing.
 
I'm starting to see an uptick. I think in regard to loss of insurance that's something I'm going to be seeing probably more next month. Many times, insurance continues for a while, and then it will end. We have been extremely busy, but I'm predicting many more patients that are needing assistance when navigating their health insurance status.

Andrew Schorr:
Okay. You're in Michigan in Grand Rapids. You do have COVID patients there.

Dan Sherman:
Correct.

Andrew Schorr:
You do have people on ventilators there.

Dan Sherman:
Yes.

Andrew Schorr:
And you have people who are cancer patients who may not have any kind of COVID diagnosis but still have their cancer medicine. For me, believe it or not folks, I have an oral medicine for the condition I have, myelofibrosis. The co-pay is over $900 per month. I have a Medicare prescription Part D plan on Medicare. And Dan's going to explain commercial insurance versus that. I have a federal plan. But I work and based on my income right now I don't believe that I qualify for free drugs or assistance. But if I lost my job, I'd be looking for that.
 
Let's talk to you, Ayesha, about that. Let's say I'm struggling for whatever reason with that whether it's $100 or $900, how can you all help?

Ayesha Azam:
That's a great question. The way we'd be able to help is that we might be able to provide you with cost-sharing assistance. The circumstance that you just listed about someone perhaps losing their job especially in today's times when things are very uncertain is very common. I recommend to anyone who has a concern about paying for their out-of-pocket costs to check us out online, because you can go through a few questions, see if you qualify for the program. Even if your income prior to the times right now, if you had a significant life change or an event, it turns out you might be able to qualify.
 
And if you do, what that means is you just fill out a short application. And if there's funding available, you'd be able to receive a grant. That grant would be able to cover not only one specific medication but any of the prescription medications for the disease state that we're covering. In your example of myelofibrosis that you were speaking about, what we'd be able to do is help with multiple medications for many folks. That can definitely be an asset, because in that way that's money hopefully that is not coming out of pocket anymore.

Andrew Schorr:
Dan, I just want to understand. You mentioned commercial insurance, and I have Medicare, and somebody else may have some other government program. Could you differentiate in how the rules for assistance vary?

Dan Sherman:
Absolutely. Because of the anti-kickback statute, pharmaceutical co-pay assistance programs are not allowed to assist people with government insurance directly. That's why we have organizations like Patient Access Network to fill that gap to help people who have government insurance, for example, Medicare like you do, Medicare Part D. If you have commercial insurance and you're on an expensive oral oncolytic, then usually, I would say 99 percent of the time, the pharmaceutical company can help you directly with your out-of-pocket responsibility that you would have for that specific drug.
 
In some ways when you think about it, the commercial insurance people are utilizing pharma co-pay programs. Those programs will help for that specific drug and only that drug. But organizations like PAN that Ayesha was talking about, they can help with multiple medications that are associated with treating the specific cancer diagnosis that you have.

Andrew Schorr:
Ayesha, then you have funds for different conditions.

Ayesha Azam:
We do.

Andrew Schorr:
Let's just say, I think you told me earlier, maybe 70 different conditions. Let's say out of 10 or 15 cancers, breast cancer, colon cancer, this leukemia, that lymphoma, you have funds. If I have one of those diagnoses, fill out the form, describe my situation, maybe be interviewed by somebody there, and then that could help with all of the medicines I have for that condition.

Ayesha Azam:
That's correct. Yeah. There were about eight other foundations in addition to PAN which provide national support to folks who may be in need of prescription assistance. Some of these foundations might have even programs that go beyond prescription assistance and cover things like travel expenses or premium assistance. It's definitely worth checking out.
 
All of these foundations, PAN included, are diagnosis-specific, so there's a specific program for each of the different conditions, and folks can come and apply based on that. What is covered at each of these foundations can be, on one end of it, it could be maybe as little as the drugs that are indicated specifically for that disease state, so if someone had breast cancer, specifically the drugs that are indicated to treat breast cancer. Whereas some of the other foundations might be as broad as covering drugs that will treat for the symptoms and side effects even that are used to manage that condition.
 
Definitely one of the great things about working with the foundation is the speed in order to obtain access and submit an application. In most of these cases, folks can fill out an application online, or they can call a call center and speak with a representative or a case manager, and the application is done in 10 to 15 minutes. Definitely recommend if someone is even curious about these kinds of resources to reach out, because it's very possible they could be eligible, and a phone call would help make sure of that.

Andrew Schorr:
Wow.

Dan Sherman:
Andrew, if I may jump in here and share some additional information. One of the nice things about Patient Access Network, the PAN Foundation, is that they've made it very easy to locate the other foundations as well. Ayesha mentioned that there are nine different foundations out there. Well, where do you go to find that information? If you go to PAN Foundation, if you Google this and then Google FundFinder, they have a fantastic tool there where if all you need to do is tell them what your diagnosis is, and it will tell you which foundations assist with your specific disease that you're looking at.

Andrew Schorr:
Well, that's a great thing. Dan, we've talked about this before. There are a lot of people who have been used to throughout their life paying their bills whether they have co-insurance, co-pays, whatever it may be, they pay their bills. Now things may be especially tough. So, there you are at Mercy Health. You've been training, and you have colleagues and peers now at more and more oncology clinics around the country, but people sometimes are just not even used to finding you. What would you say about not being ashamed to ask, if you will?

Dan Sherman:
Right, right. One of the things that I like to say to patients that are struggling with this because I think you've touched on a very important subject is people might be embarrassed about this, or they're struggling, or they might even have some severe psychological responses to what's going on. I try to explain to the patients, the person I'm talking to about this, that they're not alone. Remember, I have a full-time job. I have a colleague who has a full-time job focusing purely on assisting patients to navigate this complicated financial world once you're diagnosed with cancer.
 
If I'm full-time and my colleague is full-time, that means that there are a lot of patients going through this. That many times helps a little bit recognizing that they are not alone and that they're not the only ones that are being picked on in these types of circumstances. We could take it deeper than this as well and start understanding that this is not their fault. It's not their fault that they were diagnosed with cancer. It's not their fault that COVID-19 has occurred, and 20 percent of the population has been laid off.
 
Trying to help people process this, I think, is equally important as also assisting patients with the financial complications of this as well.

Andrew Schorr:

Ayesha, some people may have been laid off, and they're just out in the cold. Some people then are offered under a government program where they can buy insurance that the employer had been providing to them, COBRA I think you call it. But let's say they just don't have the bucks for that whether it was $1,000 a month or whatever. Does PAN help there too?

Ayesha Azam:
Yeah, case management and the whole aspect of financial navigation is so important. While it's not something that the PAN Foundation does directly, there are some tools we have that can help folks be able to navigate that. One of the resources is something that we have on our website, and we have some guides, and these are specifically designed for patients who have a cancer or any other condition that they're trying to manage and walking them through these are the questions you should perhaps ask if you're working with your insurance company. These are the questions that you could ask your doctor or your pharmacy to help make them aware that you do have high out-of-pocket costs, and it's a concern for you.
 
As Dan mentioned and as you mentioned, Andrew, those discussions are so hard to have especially as a patient if you're the ones having to initiate them. We try our best to equip folks with tools so that they can get ahead of that and be able to jumpstart those kinds of conversations.
 
The other thing that we do is that we work with a number of leading patient advocacy organizations that support folks across the U.S. For example, with breast cancer, we work with Living Beyond Breast Cancer, and what we're able to do is connect folks directly with representatives at these organizations. You can provide a little bit more guidance and hand-holding to folks so that way if they are in a situation where they're trying to figure out, "I've lost my insurance coverage. I can get back under COBRA. Is that the best decision for me, or could I benefit from any other government assistance or temporary insurance?” That's someone that they can reach out to and walk them through cases step by step and not have to generalize the information but make it specific to them.

Andrew Schorr:
That's great. Also, Dan, even before this happened, I know some people found themselves on I guess what you'd call those “skinny insurance coverage.” Then you get diagnosed with cancer, and it just isn't cutting it.

Dan Sherman:
Right.

Andrew Schorr:

Then we find out too late. Then if you layer on top of now, your income is cut. Maybe you had your own business or whatever it was, but you have less income or your spouse was bringing in the income, and they've lost their job, whatever it may be. Can you help people sort that out?

Dan Sherman:
Yeah, it's a little bit more complicated. If they're outside of the open enrollment for the ACA, it becomes difficult to enroll. However, for the states that run their own marketplace, and what I'm talking about the ACA, the Affordable Care Act, they opened up their enrollment for people who in the scenario that you just said they might have a skinny insurance policy that's not covering much at all. If you're in that situation, and if your state is running their own marketplace, I would reach out to them very, very quickly, because the open enrollment periods are—and every state is doing it slightly differently—but some states have already closed that. Some states are still keeping them open.
 
Now, that means that there are 41 states that this is not the case. The federal government is running the marketplace for them. Unfortunately, the federal government decided not to open up the ACA for general open enrollment. That does not mean that the people who lose coverage they can enroll into the ACA, but if you've not lost coverage, you're not able to enroll in that scenario.

Andrew Schorr:
I've been hearing ads here. There was a very good program on National Public Radio the other day I heard too. For instance, in California we have something called Covered California. My understanding is though is that it's open but also that and then carrying forward to these other states if I lost my job, I'm just out of insurance, then in effect I can enroll during the year.

Dan Sherman:
Correct. This is where it gets important to as Ayesha was mentioning here of wrestling between COBRA and the ACA. If you are a cancer patient and you're in treatment and you have commercial insurance through your employer but you lose that coverage, one thing to be considering is that you've probably already met your max out of pocket for the year. If you do COBRA, that max out of pocket follows you. Your treatments should be covered in full. Many insurance policies the prescription co-pay follows the out-of-pocket responsibilities. You need to make consideration of COBRA might be $200 more a month in premiums, but I've already met my out of pockets. If you go into the ACA, your out of pockets begin over again, and that could be all the way up to over $8000 in new out of pockets for the year.

Andrew Schorr:
Well, the point I want to reinforce for our viewers is that there are people, pretty astute people, super astute people like Dan who are oncology financial navigators at the clinic or hospital level. Dan's been there—I don't know if you've been in this exact job, but Dan's been there Mercy Health for 20 years. There are people though as this has gotten more complicated—which Dan referred to earlier—there are people to help you navigate, and then there are foundations like PAN that can help you and also hand you off or share you with other organizations that can provide other assistance.
 
Dan, you mentioned the drug companies. Okay, now they have programs too.

Dan Sherman:
Absolutely.

Andrew Schorr:
Sometimes even my understanding some of them even free drug programs…

Dan Sherman:
Correct.

Andrew Schorr:

...for people, so take us through what a drug company might do for someone directly.

Dan Sherman:
Right. There are different ways that the drug companies will help you even if you have insurance, or you don't have insurance. Generally, if you don't have insurance, the drug companies will be more than happy to ship you the drug for free. You have to apply for the program. Usually a social worker or a financial navigator in the oncology program will help you do that. But that tends to be fairly easy. Drug companies have also increased the opportunity of getting free drugs even if you have insurance. If the out-of-pocket responsibilities that you have for that specific oral drug is still unaffordable for the individual, your circumstance is you're paying $900 a month for the drug. Most people cannot afford that. Then the drug company says, "Okay, there's no co-pay assistance foundations available for you, so we're going to provide you the drug for free.
 
I was actually on the phone today with two different drug companies, and they are doing everything they can to expand those type of services with what's going on with COVID. So they're making it even easier to apply for those programs and to ship out the drug faster. It's very impressive in my opinion what different companies are doing and how we're adapting to all of this. I'm seeing a consistent theme that organizations are adapting and changing to help people who need access to these drugs.

Andrew Schorr:

That's good to know, because we're aware of how expensive these drugs are. I should say, and in my case, very effective medicine, life-saving medicines, but they're costly. So if the manufacturer can help in this kind of struggle, that's great. Dan, let's just walk through how it would work. Let's say I'm at Mercy Health, and I've seen my doctor, and they write a prescription for something. And it's set up, and it's going to come mail order, and I find out what the co-pay is. I say, "Oh, my God, how can I do that?" Or, "I lost my job." Or, "I just don't have the income for it." Do I say to the nurse, to the doctor, "Is there anybody here at the clinic who can counsel me on this?" How does the process work where you are?

Dan Sherman:
Absolutely. Being proactive about this is just very, very important. As soon as the patient is aware that there's an affordability issue, they should reach out to the nurse, to the social worker. If the cancer program has a financial navigator, reach out to the financial navigator. When the financial navigator or the social worker starts enrolling people into these programs, the turnaround on these applications are fairly quick. Usually within 48 hours, we have an approval, and then the drug company will ship the drug typically directly to the patient. It could be four or five days, and the patient has the medication. Communication is the key issue of notifying the appropriate members of the team that has an issue going forward.

Andrew Schorr:
Ayesha, I imagine you all are getting more calls now, I would think.

Ayesha Azam:
Yeah, it's definitely a busy time. I love what Dan said about being proactive about if you do have a financial concern, if you've been recently diagnosed or maybe your therapy changed or maybe you just had a change in your circumstances, and now the out-of-pocket cost is more than what you're able to manage. That's okay. The important thing to remember is even if you come to foundations or you go to a manufacturer and you're trying to receive assistance, even if it's for past claims, a lot of times organizations still are able to help. We know for Medicare a lot of folks might have really high out-of-pocket costs that they're paying in January and February, and then those costs start to trail off and decrease as the months go on. Definitely I think reaching out and being mindful that being proactive is key, and it's so helpful, because it'll allow you to find what you need. Then also just always feel free to ask if it was a past expense.

Andrew Schorr:

Okay, what about living expenses? We talked about drug costs. Do you have any programs now for helping me? I might be worried about making my rent.

Ayesha Azam:
Yeah, yeah, that's a great point. Just a couple of weeks ago, the PAN Foundation launched a program related to supporting folks during this time of COVID. This program is not only available to folks who are diagnosed with COVID, but also folks who might be self-quarantining, because they recognize that's what's best for their health or their provider has recommended them to do so. Yeah, definitely.
 
Those programs are really intended to cover nonmedical expenses whether it's groceries, whether it's making sure that you can get any over-the-counter medications, if you are feeling a little bit down, that you might be symptomatic. If you need to pay for a telehealth visit or even going to a doctor facing those travel costs, these are the kind of things that could help with.
 
Dan mentioned that tool that we have earlier called FundFinder, which is a free service. Anyone can sign up for it. It's a super easy, two-step application process. You can search COVID on there and see a list about five or six different programs across foundations, other organizations are also covering nonmedical expenses to be able to help folks get what they need. So definitely a great resource out there, and hopefully it's supporting a lot of people that may need it.

Andrew Schorr:
And there are some other organizations, and you seem to be pretty networked related to—I know there's one called Family Reach Foundation, I know, out of Boston. There are some others. You all share information. In other words, you may have a certain fund, and my understanding is sometimes funds run out of money, right? Somebody else might have another foundation or group might have support, right?

Ayesha Azam:
That's completely true. Our goal is if there's assistance out there somewhere, we want to try to get you there, because that's what's going to help you. What we've tried to do is put several resources in one place, and so that way regardless of who you are or what you're looking for, you don't need to worry about going to all of these different websites and trying to chase down the web page or the information you need. You can just go to one place and be able to see who's open and get a sense of who might be able to help you.

Andrew Schorr:
Well, that's all good news. People just have to take advantage of it. Dan, when there's assistance, how long does it last? In other words, is it just going to get you through this month? How long does it last for? I'll ask Ayesha how they operate too, but tell me, Dan.

Dan Sherman:
Generally it's a year. For example, pharmaceutical companies if they start offering free drug, they will typically do it for one year. Most foundations do the same thing as well. If you're looking for assistance for more of your basic needs, you had mentioned Family Reach, there's The Pink Fund, there's New Day Foundation, there are lots of them out there. They tend to say, "Well, here's a grant that will pay your mortgage for two months or three months," something like that. There's usually a one-time interaction that is made.

Andrew Schorr:
Okay. Ayesha, anything else about the duration? Let's say it's for the year, and I'm still stuck. Do I go through the process again, or what happens?

Ayesha Azam:
Yeah, Dan's totally right. It's generally for a year across all foundations. An important thing to note about it is depending upon the organization, it might be for 12 months from the time you enroll, or it might be for the calendar year. Folks have Medicare insurance, they have a commercial insurance, their plans typically are from January through December. Some foundations may operate like that. The PAN Foundation in particular operates on a rolling cycle, so if someone were to sign up today, they'll get 12 months of assistance from today into next April.
 
But let's say folks run out of money beforehand. Let's say it's a few months, in and they've exhausted the funding they have. As long as the program is open at the foundation, they can generally come back and ask for additional funding. We recognize everyone has a different plan. Some people's costs may be a little bit higher than others.

Andrew Schorr:
Dan, I want to take it just beyond what we talked about related to prescription medicines, and I want to talk about hospital costs for a minute. My understanding is, someone as we have more testing, will be able to get a coronavirus test for free.

Dan Sherman:
Correct.

Andrew Schorr:
Let's say I develop the illness, and I'm in your hospital, and I am out of luck with insurance or something like that. Does the hospital just eat the cost? Do foundations play a role? How does that work? Because, again, I'm out of money, but I'm sick.

Dan Sherman:
Right. There are several different scenarios there. If you have insurance, a lot of insurance companies are waiving the deductibles and co-pays for COVID-19 associated treatments and diagnosis. If you don't have insurance, the federal government in the stimulus package that they passed is reimbursing hospitals for the self-pay patients that are coming into the hospital. I think all parties, insurance companies, the federal government, the hospitals are doing everything they possibly can to encourage patients if they have COVID-19 to come in, to be tested and to be treated. I know it's easy for me to say this, but I would hope that that should be the least of worries for patients when it comes to the financial aspects of the treatment cost of COVID-19.

Andrew Schorr:
Okay, and just again to underscore, the cost of testing, there's no cost of testing?

Dan Sherman:
There should not be a cost associated with it. Right.

Andrew Schorr:
So we want people as tests roll out to be tested, there will be other kinds of testing, antibody testing, as we try to open up. There is a real effort to do that in Michigan where you are. You're in Maryland. You both have really good governors who have been really careful in Maryland and in Michigan about this. I know they're trying to plan how can they get things going again, so we're concerned about testing.
 
Just a couple of more questions related to the medicines. Dan, first of all, let me just go through and let's see if I get it right. If I have commercial insurance, which might be Blue Cross or Blue Shield or United Healthcare or whoever, commercial insurance, and I'm not on Medicare or some other government—not on Medicaid, right? None of those government programs. It could be that there is co-pay assistance directly from the company, right? The co-pay cards and all kinds of things like that.

Dan Sherman:
Yep.

Andrew Schorr:
If I'm on Medicare or another government program, I might be working with a foundation like PAN to help me navigate.

Dan Sherman:
Right.

Andrew Schorr:
Right? In some cases with the help of someone like you, a financial navigator, there might be a determination with a drug company for a specific medicine that I qualify for free drug for the rest of the year or a 12-month period, something like that.

Dan Sherman:
Correct.

Andrew Schorr:
And the drug company sends me the medicine.

Dan Sherman:
Yes.

Andrew Schorr:
Okay, okay.

Dan Sherman:
I want to point out another thing as well. Many people might think, "Well, I don't qualify for these. I make too much money." For example, the PAN Foundation, most of their funds you have to be below 500 percent of the federal poverty level, which is about 80 percent of the population. These programs are more generous than what many of us tend to believe. I would encourage if patients are listening to this, and they're thinking, "Well, I think I make too much," go ahead and try anyway, because most people do get the assistance.

Andrew Schorr:
Anything you want to say about that, Ayesha? Because, again, I've seen things on the news of middle class people lined up at food banks and all kinds of stuff like that. They're not in jalopy cars. They've probably been doing okay until now. Can they go to your foundation and get some help?

Ayesha Azam:
I completely agree. A lot of times folks are thinking about what their total income is. They might not be factoring in when they're talking to organizations like PAN or to the financial navigator, “This is my circumstance as of right now, and right now is what really matters.” Or if you know that there's an unexpected or unfortunate circumstance where you may be losing your job very soon, mention that as well, because those are things that can help factor in and make it that if there's an opportunity for folks to help and organizations to help that we can step in and be able to work together.

Andrew Schorr:
Here's a question we got in from Lynn. She said, "Well, when on Medicare, what financial info are you going to need to qualify with it?" So what do you need from me?

Ayesha Azam:
Yeah, that's a great question—not too much information, which is a good thing. A lot of foundations, PAN included, are mostly paperless. You could fill out an application online, or you could give us a call and provide the information. At a high level, it's demographic information. It's your physician's information so that we understand where you're receiving treatment, the name of your diagnosis and medication, and your household size and income. Often by household income we're referring to if you did file taxes, what your adjusted gross income was last year, and if you didn't, what are you receiving through any—whether it's Social Security payments or anything else.
 
That information if you're on the phone and provided over the phone, the decision whether or not you are eligible is often provided immediately across not only PAN but other organizations as well. It's not a very long waiting time. If you're working with a pharmacy to submit a claim, often you could get that claim submitted by the pharmacy the same day.

Andrew Schorr:
Wow, so let me…

Ayesha Azam:
And you can provide that information over the phone.

Andrew Schorr:
…let me see. Do you need me to send you my tax return? No.

Ayesha Azam:
There might be a small number of folks we follow up with. Generally, if we're following up for any information, it's because you've had a circumstance in the very recent past. For instance, maybe we're looking and seeing your income from last year, but you had a change in the last couple of months. It's really just for us to connect the dots, although 90 percent of the applicants we're not asking or receiving any paper documentation.
 
One of the great things about working with organizations like Dan mentioned, financial navigators and healthcare providers and pharmacies they're there to serve and make sure that patients and people who are trying to manage and mitigate the network and figure out what to do, that they're there for them. Often financial navigators, healthcare providers, pharmacies can apply on behalf of patients to these programs. It's not like they have to come in and try to do it independently. They're more than welcome to, and we'll help them, but if they wanted extra support and wanted to make sure and have someone help them on their behalf, that's okay too.

Andrew Schorr:
Dan, you mentioned along the way the term social worker. We actually had on yesterday the former president of the Oncology Social Worker's Association, Eucharia Borden. A social worker at a clinic or hospital such as yours can help navigate this too, right?

Dan Sherman:
Right. If the oncology practice that you're going to doesn't have a dedicated financial advocate or a financial navigator, then the next thing that I would be asking for is, "Do you have a social worker that I can work with on this?" Many social workers are very aware of these co-pay assistance programs and patient assisted programs available out there.

Andrew Schorr:
Just want to pick up on something Ayesha said to make sure we've got it right. If I go through a program such as hers or you do it in some other way, Dan, it sounds like she said we could go to the pharmacy the same day? How quickly? Because I need the medicine.

Dan Sherman:
Right. One of the nice things about organizations like PAN, the Patient Advocate Foundation, you have cancer care, The Leukemia & Lymphoma Society, many of these organizations you can submit the application online. Ayesha mentioned that it's very easy. It takes about, if you know what you're doing, 10 minutes. You put in the demographics. You put in what their income is. Their system will do an automatic approval for that individual if they can verify the income information. It's not unusual that I'm sitting down with a patient, we are applying for the program, we get an instant approval, I'll print off the approval letter. We'll walk down to the pharmacy together. I'll give the paperwork to the pharmacist, and within 10 minutes that patient is walking out with their medication, and it's already been paid for by the foundation.

Andrew Schorr:
Okay. I just want to mention an experience I had. I switched from one expensive medicine to another in January. I was curious whether with the new drug company I would qualify for any assistance. This was at the University of California San Diego, Moores Cancer Center, so pretty big place. Sure enough, there was someone like Dan there who's a financial navigator. That's his job. He worked with me to gather up documents, and then he worked with someone from the drug company for the medicine I had. They had them separated by regions. This was a go-to person for the California region, and then they went over my documents and whether my income was such where I could qualify.
 
I think I've heard since then from that company that as you said Dan, they're liberalizing their policies. I didn't get it then, but I probably should go back and see whether it's changed. What would you say if you didn't get it previously, are we in a little bit of a new world now?

Dan Sherman:
I think we're in the new world. I know that pharmaceutical companies are trying to make it as easy as possible for patients who are on their specific medications to get access to a medication. Like I said, I was on the phone with a pharmaceutical company earlier today, and they're saying if people are calling, and we are pursuing the free drug program, but there are forms that need to be completed, we're arranging for a shipment of 30 days just to happen immediately while we're working on all of the paperwork.

Andrew Schorr:
Oh, wow. That's very powerful.

Dan Sherman:
The other thing I failed to mention too, I talked about for example PAN, their income criteria is 500 percent of the federal poverty level. Household size of two, that's right around $80,000 a year. But if you have commercial insurance and you're working with pharmaceutical companies on co-pay assistance, they tend to be a lot more liberal on the income. Some of them don't even ask the income information. If you're on the drug, you can get co-pay assistance through their organization. I've had people making over $200,000 a year and still qualify for assistance or even free drugs as well.

Andrew Schorr:
Whoa. I've got to check. Okay. So, if I get it right, just as we sum up, is the effort by the healthcare insurance community, the foundations, the navigators, the pharmacies, the drug companies—we're talking about cancer patients—get the treatment they need and deserve, right? And that the financial issues should not be a barrier, is this make-believe, Dan, or is this for real?

Dan Sherman:
I think it's for real. Can I say that 100 percent of people that come across my desk that I can fix their problem? I don't think that's a fair statement. But 90 percent to 95 percent of people that are coming and saying I need help, we can solve that problem.

Andrew Schorr:
Okay. All right, folks. For our audience as we wrap up, you need to see the Dan Shermans of the world where you get care, and if there's not a financial navigator, is there an oncology social worker who can help you navigate it? Ayesha, could you give us your website address or if you want to give the phone number too? And you also are a window in all the other foundations too. What is it?

Ayesha Azam:
Sure. Our website address is PAN, P-A-N foundation.org. If you go on there, you can apply, you can check out other programs as well, you can reference that tool FundFinder, that Dan mentioned. The best thing to do on there is just search for your disease or for the medication that you're interested in and go from there. If it's easier for you to call, you can call 1-866-316-7263. We'll be there for help.

Andrew Schorr:
Thank you. I just want to point out one thing to our audience. Dan has been on our programs before. Dan, besides being at Mercy Health Care, goes all around the country. Normally he'd be on planes and speaking and doing all that. He has been really a leader in training others in this oncology financial navigator world. Dan, I want to thank you for your leadership, because obviously you're a fountain of knowledge. As you have others who are getting to that point, we really appreciate it. It makes a huge difference for us. Ayesha, thank you for what you're doing too. Thanks to others who may be listening or involved in this field in liberalizing these policies in a time of great need for so many. Dan, any closing comment?

Dan Sherman:
Well, I would just like to thank you, Andrew, for getting the word out. I love your passion and your passion of helping patients get access to medications. Thank you for getting the word out.

Andrew Schorr:
Well, thank you. Ayesha, any last comment from you?

Ayesha Azam:
I agree. Thank you so much for all you do. Everyone's here to help. If you have any questions, if in need, just reach out and ask.

Andrew Schorr:
Wow. Ayesha and Dan, you were just fountains of knowledge on these complex financial issues. Thank you so much for encouraging us to really look at all our possibilities and seek out help from people like you and your partner organizations. Certainly, it gives us great comfort that the policies are being liberalized so that we can get the help that we need and deserve.
 
Thanks again for being with us. Keep up the good work, and I know you're there for us, and our audience will take advantage of your advice. I want to thank our sponsors for supporting this program. They are just so committed to the community. They are Pharmacyclics, Janssen and Incyte. So thanks to them. We look forward to doing more webinars on this subject as we navigate these financial issues and many other important issues that we cover on Patient Power.
 
If you have a comment or suggestion, just remember to send it in to comments@patientpower.info. Thanks for joining us. I'm Andrew Schorr. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
 
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