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Battling rising drug prices while fighting a life-threatening illness

Posted at 8:09 PM, May 23, 2016
and last updated 2016-05-24 09:50:16-04

HOLLAND, Mich -- As drug prices continue to soar, Americans are paying more for prescription drugs than any other country.

The global pharmaceuticals market is worth $300 billion a year and is expected to rise to $400 billion within three years, according to the World Health Organization.

The costs of those drugs is financially crushing for some.  It's especially tough for one West Michigan woman who takes 20 medications a day.

Rising Drug Costs Pill Bottles

Megan Litvack,23, suffers from five chronic illnesses. She was born with three and diagnosed with two others. She takes 17 pills orally and three others through an I.V. daily.

"I wouldn’t wish this upon my worst enemy," Megan said. "It’s not easy to fight for your life when your body is fighting against you."

Rising Drug Costs Pills in HandMegan suffers from Ehlers-Danlos syndrome, EDS, Von Willebrand disease, fibromyalgia, mast cell activation disorder and Gastroparesis. She was recently placed under the care of Hospice in Holland.

"She is on a lot of medications. Some of them are things like vitamins that help her function better. Others are symptom management to help her sleep, help her pain," said Dr. Alice Emery of Keystone Medical Services and Hospice of Holland.

Inside her food pantry are the dozens of Megan's medications, all separated by drawers. Cheri, Megan's mother, tells FOX 17 Megan's health first started to decline when she got whooping cough on a plane because someone wasn't vaccinated.

Rising Drug Costs Fist Bump

"If she wouldn’t have gotten the whooping cough, her immune system wouldn’t have been so compromised," Cheri said. "It has affected me at every level. I have shed a few buckets of tears."

It was a battle no one saw coming, piled with expenses no family should have to pay.

"I never thought that I would have to fight every day for my life," Megan said "I went from having a very healthy, very normal life, to being a 23-year-old in a hospital bed, not able to move and it has affected every aspect of my life."

Cheri says Megan's medication costs just keep rising and that "it's getting out of hand. It's a constant headache."

The price she's paying for Megan's mast cell activation drug is staggering. For one box, the family pays $900.  Cheri says it's up $650 from last year.

Rising Drug Costs Mass Cell Activation Drug

Dozens of treatments and pills are adding up to thousands in out of pocket costs. Cheri says their co-pays alone have gone up at least five times over the last five years.

Angie Stropkai, a clinical pharmacy specialist at Spectrum Health Medical Group, says healthcare costs in general are becoming more expensive.

"I think it’s a multitude of different reasons of why prescriptions are becoming so expensive. I think the research and development that go into these medications are becoming higher," said Stropkai. "Unfortunately those costs are actually having to be helped be supplemented by the patients who have to pay for them."

The top drug makers topped $1 trillion in sales in 2014 and according to the World Health Organization, that number is only growing.

"The price of Lantus alone, which is an insulin for patients who have diabetes, has increased I think almost two to three hundred percent over the years, so it really puts these patients in such a predicament of choosing to get their medications or choosing to use that money for living expenses, food or gasoline," Stropkai said.

That's where Priority Health's Medication Therapy Management program comes in. The program supports local pharmacists while helping patients understand their prescription drugs and control out-of-pocket costs. Priority Health is devoting nearly $3 million to expand its pharmacy management programs throughout Michigan.

"I would say a majority of my patients have at least 15 or more medications, so that’s really what I’ve been focusing in on trying to streamline medications, help improve their medication management, so that they don’t have as many medications," said Stropkai.

This is how the program works; qualified Priority Health members and their physician and pharmacists evaluate the patient’s prescription drug use and identify potentially dangerous and costly medication errors during a one-on-one, 30 to 45 minute medication review. During the review, the pharmacist evaluates the member’s prescriptions, simplifies their medication routines and identifies and resolves any drug-related concerns. The program is saving participants on average of $60 per month.

"It is an amazing opportunity for us to say one of our primary focus’ on meeting with patients is making sure we can break down some of those barriers they have with costs," Stropkai said. "Explaining to the patients the 'why' behind or the mechanism behind 'how' that medication works, really helps them understand the reason they need to be taking it the way it was prescribed."

FOX 17 spoke with Aaron Givens who has been with Priority Health for 20 years and takes ten medications for his type 2 diabetes.

"It’s probably why I’m still alive, you know. Diabetes will kill you if it’s not kept under control. Teaching me how to manage my diabetes was probably the most important thing to me," he said.

Priority Health is offering Medication Therapy Management programs in pharmacies across the U.S., including Meijer, Walgreens, Spartan Stores, Rite Aid, CVS, Wal-Mart and several other local pharmacies.

According to a study by the IMS Institute for Healthcare Informatics, if doctors and patients used prescription drugs more sensibly, they could save the U.S. health care system at least $213 billion a year by reducing medication overuse, underuse and other flaws that could cause complications and longer, more-expensive treatments.

"I think that consumers are probably looking for any avenue they can take to find lower costs," said Erica Clark, the Director of clinical pharmacy programs at Priority Health.

Consumers like Cheri and Meg will keep fighting no matter how high those drug prices climb.

"I think that God decided to pick me because he knew I could handle it," Meg said.

Megan hopes her story inspires others to never give up, no matter the obstacles they face. If you would like to learn more about Megan's journey, you can view her blog here.

Members interested in learning more about Medication Therapy Management services can call Priority Health at 800.942.0954 or visit priorityhealth.com and search under the member section.

Other ways to save money on prescription drugs

According to Michigan.gov, comparison shopping for prescriptions is key. Websites like MichiganDrugPrices.com allow consumers to view prices on 150 commonly prescribed prescription drugs.

Searches on the Michigan Drug Prices website show that prices for the same drugs can vary from pharmacy to pharmacy by as much as 500 percent, according to Michigan.gov.

If pricing for your prescription drug was not listed on Michigan Drug Prices, you can call pharmacies in your area to comparison shop. You can also ask your pharmacy to price match or transfer your refillable prescription drugs.

Another way to save money on prescription drugs is needymeds.com.

Once you're on the website, type in the name of your medication. The site will pull up several different options, many of them, will include coupons.

Once you get that coupon, print out the form, fill it out and give it to your doctor to sign.

After it's signed, mail it to a participating drug company and they will send you the drug for the lower price.

Beneficiaries with Medicare who have limited income and assets may qualify for Extra Help with the costs of their prescription drugs. It's called the Extra Help Medicare program, or Low Income Subsidy (LIS). It's known to minimize costs for prescriptions under Medicare Part D, or a stand-alone drug plan. Once a person is approved for Extra Help, his or her insurer is notified, and the Medicare drug plan's monthly premium and yearly deductible are nearly or completely wiped out.

The state also suggests asking pharmacies about discount prescription drug programs, sometimes retailers will offer these programs for a small annual fee.

Another great way to save money on your prescriptions is by asking your pharmacist is a generic version of the drug you are taking is available.