LCFA’s Speakers Bureau member, Annabelle Gurwitch has a perspective in the Outlook section of The Washington Post. Annabelle is an actress and the author, most recently, of “You’re Leaving When?: Adventures in Downward Mobility.” In the Washington Post opinion piece, she illustrates, in her witty style, how some healthcare plans that are supposed to save patients money can end up costing them dearly.
A lung cancer diagnosis was the shocker to the year Annabelle Gurwitch already had going in 2020. She went to have a Covid test and left with a stage 4 lung cancer diagnosis. Annabelle’s story of an accidental lung cancer diagnosis is a very common story among lung cancer patients. In Annabelle’s case, getting an accurate diagnosis that identified her lung cancer biomarker, set her on a treatment course that is manageable as well as saving her life.
Participating in a co-pay assistance program that provides up to $26,000 per patient per calendar year for her targeted therapy medication, which retails at $14,000 per month, Annabelle found herself entangled in an increasingly exploitative scheme where pharmacy benefit managers (PBMs) contract with secretive third-party adjusters commonly called co-pay accumulators and maximizer programs to process “specialty medication” prescriptions.
“When you take up residency in Cancerland, as I did when I was diagnosed with Stage 4 lung cancer in 2020, you regularly hear yourself described as “battling” cancer. With my one-pill-a-day biomarker-directed therapy, I prefer to say that I’m “tackling” cancer. But if I am at war, it’s with an insurance system that works more like an extortion scheme.
In mid-January 2022, my phone rang early in the morning. This is my recollection of that call.
“Hi, this is Unintelligible Name from SaveOn.”
“Who? I don’t use Sav-On pharmacy.”
“We’re not Sav-On pharmacy, we’re SaveOnSP, specialty pharmacy.” SaveOn is pronounced exactly the same as Sav-On, just to be more confusing.
“I just changed insurers,” I said, “and I’ve been in close contact with my new plan. They contract with Express Scripts, who’ve assigned Accredo as my specialty pharmacy.”