Affording costly blood thinner with no job and no insurance

Programs available for costly drug

Q:My relative was discharged from the hospital with a prescription for Lovenox. She is uninsured and unable to work. She was injured in a shooting. One pharmacy quoted us $700 to fill the prescription. We tried to get help but were told she does not qualify for Medicaid. Is there any place that will help?

Answer: Lovenox is a blood thinner made by drug maker Sanofi-Aventis.

There are different types of blood thinners, said pharmacist Leonard Edloe, owner of Edloe's Pharmacy in Richmond.

"She could eventually go to Coumadin to prevent her from having a clot," Edloe said. "But what happens with Coumadin, it has what we call a long induction period. It would be a week before she would get the effect. That's why we use what's called low-molecular-weight heparin, which the Lovenox is. It is very expensive. You are talking about $600 to $700."

Heparin, which also acts quickly, has been around longer and is cheaper. However it's more complicated than Lovenox to administer, requiring more tests to make sure the dosage is correct and that side effects are minimized. And while the drugs are sometimes interchangeable, they are not always, depending on why the doctor is prescribing it.

For help affording Lovenox, Edloe said he would refer the patient to one of the free clinics (http://www.vafreeclinics.org) or federally supported community health centers (http://www.vacommunityhealth.org) that have pharmacy services, or try to get them qualified for Virginia Commonwealth University's indigent-care program. Many drug companies have assistance programs, but the application process takes time.

Donald F. Brophy, an associate professor at the VCU School of Pharmacy, said the assistance programs there try to get patients enrolled right away so they can go home with needed medications.

Though it would not be of immediate help, there is a Virginia program that helps crime victims recover some of their expenses, including unreimbursed medical expenses.

Virginia's Criminal Injuries Compensation Fund (http://www.cicf.state.va.us) last year paid 1,510 claims, not all of them medical, however. The program is funded by court fees, assessments on offenders, restitution and a federal grant.

The average payout is about $2,300, said Shannon Freeman, the program's ombudsman. While a claim is pending, providers can't turn the applicant over to a collection agency. Freeman said they are sometimes able to get bills discounted or written off for clients.

Contact Tammie Smith at (804) 649-6572 or .