January 2014
Julie
Kuennen
,
RN
Home Health
Torrance Memorial Medical Center
Torrance
,
CA
United States
Julie acts as the Utilization Nurse for one of our insured populations. Recently we received a referral on a post renal transplant patient that was admitted to TMMC with Endocarditis and CMV. He was discharged to HH with 2 IV antibiotics and oral Valcyte to treat CMV. The HH RN told Julie that the patient could not afford the drug at its discounted rate of $430 for a 30 day supply. The plan for the course of treatment after the 30 days was every other day indefinitely. The patient did not have the resources to continue this expense for the rest of his life. Julie spoke to the insurance carrier and Medicare part D with no available assistance for this patient from any party. But she would not give up.
She researched and assisted the patient in applying to an assistance program through the drug manufacturer. The patient was denied. She still would not give up on this patient. Working with his physician she was able to change the drug from oral to IV for a limited period of time so that it would be covered by insurance. This only bought him a little time.
As the days went by, he became severely neutropenic and had to start IV Neupogen until the other drug was complete. Time was running out. The patient was getting close to the limit of time he could be on the IV route of this drug and Julie still did not have an oral solution. The worst case scenario is that he would become susceptible to endocarditis again or other complications related to bowel disease would emerge. She kept searching for a solution.
Julie called pharmacies in the community, kept calling the health plan, the drug company and finally, due to her relentless persistence she got the drug company to review his case and they have provided some financial support for this patient! She proved to be an incredible patient advocate and her work could very well have saved this patient's life.
From the wife of the patient; "I am so appreciative. I cannot express how much we appreciate what she did. I pray for her every day. Thank you to Julie for her help and God Bless for everything you do."
From the son of the patient; "This nurse is very rare. She had the passion to keep trying. Dad is doing great - right now he's doing push-ups and sit-ups- no seriously he is doing great now that he is on the medications. We are so grateful for what she did."
She researched and assisted the patient in applying to an assistance program through the drug manufacturer. The patient was denied. She still would not give up on this patient. Working with his physician she was able to change the drug from oral to IV for a limited period of time so that it would be covered by insurance. This only bought him a little time.
As the days went by, he became severely neutropenic and had to start IV Neupogen until the other drug was complete. Time was running out. The patient was getting close to the limit of time he could be on the IV route of this drug and Julie still did not have an oral solution. The worst case scenario is that he would become susceptible to endocarditis again or other complications related to bowel disease would emerge. She kept searching for a solution.
Julie called pharmacies in the community, kept calling the health plan, the drug company and finally, due to her relentless persistence she got the drug company to review his case and they have provided some financial support for this patient! She proved to be an incredible patient advocate and her work could very well have saved this patient's life.
From the wife of the patient; "I am so appreciative. I cannot express how much we appreciate what she did. I pray for her every day. Thank you to Julie for her help and God Bless for everything you do."
From the son of the patient; "This nurse is very rare. She had the passion to keep trying. Dad is doing great - right now he's doing push-ups and sit-ups- no seriously he is doing great now that he is on the medications. We are so grateful for what she did."