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Prescription assistance program offers discount medicine

Without Sanford Health‘s prescription assistance program, Jeff Nichols said he wouldn’t have food on his table through his battle with cancer.
After noticing bowel issues, Nichols was diagnosed with pancreatic cancer in early summer of 2021. A former cigarette smoker for 40 years, Nichols was also diagnosed with COPD, which in turn led to cancer in his lymph nodes. He lives in Armour, South Dakota, and has been traveling to Sioux Falls for his treatments over the past year.
A cancer diagnosis puts a financial burden on everyone, but Nichols said he’s felt it especially hard.
“Because of my health, I can’t work, so I can’t get insurance through a job. I’m not old enough for Medicare, and Medicaid is nonexistent to a person like me. I just can’t get it. My wife has a job where she makes over $800 a month, so I can’t get on any programs because she makes over $800 a month,” he said.
Request financial aid: Medical bill payment help at Sanford Health
A social worker at Sanford Health told him about the prescription assistance program. Nichols said it was difficult to put into words how thankful he was for the program.
“I’m thankful enough to do this interview,” he laughed. “I’m very grateful. It’s put food back on my table and gas in my tank to get back up here for my prescriptions. I’ve saved hundreds, thousands of dollars.”
That’s exactly why the program was created, said senior executive director of pharmacy at Sanford Health, Jesse Breidenbach.
“Anyone who’s worked in a pharmacy has seen patients come up to the counter, only to walk away without their medications because their copays are too expensive. They can’t afford it. Some people are making decisions between buying their medication or getting groceries,” he said.
Kari Hatfield, an enterprise pharmacy business manager at Sanford Health, said the health care provider uses a “scoring grid” to see if patients qualify for the program.
“If a patient gives any indication that they can’t afford their medication, we are able to presumptively qualify these individuals. There is a scoring grid that the pharmacist evaluates based on what the patient fills out. They disclose their income level, and we can provide a tiered level of assistance,” she said.
Hatfield said many patients fully qualify “at the counter that same day.”
“They get their 10-day fill of the prescription, and they’re able to leave with their medication. In order to get qualified for the full six months, they do have to provide tax returns or complete a full process by being vetted through the charity department.
“If they do that and they’re approved, they get a letter saying they can have assistance for six months. After six months, they’ll have to reapply, which is a standard policy at Sanford,” she explained.
Breidenbach said financial troubles are very common, and it’s important for patients to be honest with their providers.
“Share with them what’s really happening. We want to help people get connected to this program, and help their health improve and see the benefit of medications they should be taking, even when they can’t afford it. And it’s nothing to be embarrassed about. Medications are very expensive.”
He explained that when patients don’t take medications early, illnesses tend to progress.
“If patients don’t start therapies, it leads to more serious health consequences down the road.”
Part of Sanford Health’s mission is meeting patients wherever they are. Hatfield said this program is just one more example of that mission lived out.
“It shows Sanford is willing to continue to help our patients find new, innovative ways to help connect them to the help they need. There’s a lot of programs out there, and I don’t think patients always know everything that is available. So, it’s another access point, and providing the care that patients need,” Hatfield said.

Posted In Cancer, Community, Sioux Falls

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