How Specialty Pharmacies Help Patients Navigate Insurance and Prior Authorization When a physician prescribes a specialty medication, patients often expect the next step to be simple: fill the prescription and begin treatment. Specialty medications can work very differently. Before treatment begins, there may be a second process involving the patient’s insurance company, prescribing physician, specialty...

Conditions Commonly Treated with IVIG Therapy Intravenous immunoglobulin, commonly called IVIG, is a specialized therapy used to treat a variety of immune, neurologic, and hematologic conditions. Patients are sometimes surprised to learn that two people receiving IVIG may have completely different diagnoses. That is because IVIG can play different roles depending on the condition being...

Many medications that once required patients to remain in a hospital can now be administered at home for appropriately selected patients. Home infusion therapy can involve intravenous or subcutaneous medications, specialized equipment, pharmacy services, nursing support, patient education, and ongoing coordination with the prescribing physician. CMS describes home infusion therapy as intravenous or subcutaneous administration...

Insurance coverage does not necessarily mean a specialty medication will be affordable. Even after an insurer approves treatment, patients may still face deductibles, copays, or coinsurance. For certain commercially insured patients, a manufacturer copay assistance program may help reduce some of that out-of-pocket responsibility. Patients commonly ask: What is a manufacturer copay card? Who qualifies?...

Being prescribed immunoglobulin therapy can bring a long list of questions. Patients often want to know what immunoglobulin actually is, why their physician prescribed it, whether they will receive IVIG or SCIG, how long treatment takes, whether they can receive it at home, and what insurance will require before treatment begins. Those questions are understandable...

Chronic inflammatory demyelinating polyneuropathy—more commonly called CIDP—is a rare neurologic disorder that affects the peripheral nerves. For patients who are newly diagnosed, the terminology alone can feel overwhelming. Patients may hear words such as: Demyelination Peripheral neuropathy Nerve conduction Immunoglobulin Loading dose Maintenance therapy IVIG SCIG And then come the practical questions: Why did my...

For many patients receiving recurring infusion therapy, the possibility of receiving treatment at home sounds appealing. No driving to an infusion center. No parking. No spending additional time traveling before and after a several-hour infusion. Instead, an experienced nurse comes to the patient. But home infusion is not appropriate for every patient, medication, or clinical...

Few messages are more frustrating than learning that an insurance company has denied coverage for a medication your physician prescribed. Patients understandably wonder: Does this mean I cannot receive treatment? Why was the medication denied? Can my doctor appeal? How long does an appeal take? What paperwork is needed? Will insurance eventually approve it? What...

Patients who are prescribed immunoglobulin therapy often encounter two terms: IVIG and SCIG. Both treatments provide immunoglobulin, or antibodies collected from donated human plasma, but the way the medication is administered can be very different. IVIG stands for intravenous immunoglobulin. It is infused directly into a vein. SCIG stands for subcutaneous immunoglobulin. It is administered...

My Doctor Prescribed a Specialty Medication. What Happens Next? You’re Not Alone in This In my 18 years as a pharmacist—across hospital, clinical, and ambulatory care settings, and now here at Mercy Pharmacy Group—I’ve sat across from many patients in the exact moment this article is about: prescription in hand, relieved a treatment exists, and...