Navigating insurance, medical bills, and prescription costs can be stressful, especially when you rely on pricey meds to manage pulmonary hypertension (PH) or pulmonary arterial hypertension (PAH). “I have Medicare with a prescription plan. I sure hope that it will cover the cost of any meds that I need because the shortness of breath is worsening. I think I will need more medication soon,” shared a myPHteam member.

“I’m still waiting for my disability to be approved, so I am without insurance as of January 1,” another member explained. “There are programs out there that work with the manufacturers of PH drugs and help cover the cost of those medications for me.”

Fortunately, specialty pharmacies may enable access to medications that are otherwise unaffordable. Here are some essential resources to help people with PH and PAH get their prescriptions promptly, along with clinical support, without breaking the bank.

1. Accredo

Accredo is an online pharmacy. Once you call the company to set up your account, they’ll contact your prescribing physician and insurance company about your prescriptions. Medications are shipped to your home or doctor’s office at no extra cost. You can then register online to manage your account and schedule refills. Accredo can send you phone calls, emails, or texts to remind you when it’s time to refill your medication.

The benefits of using a specialty pharmacy like Accredo include access to trained health care providers who understand PH and PAH. You can also talk with experienced nurses and pharmacists to learn about your medication’s side effects. In some cases, nurses will even come to your house to help administer infusions. If you have questions about your treatment, you can talk to a health care provider over the phone or online.

PH and PAH therapies that may be serviced through Accredo include:

• Ambrisentan (Letairis)
• Bosentan (Tracleer)
• Epoprostenol (Veletri, Flolan)
• Iloprost (Ventavis)
• Macitentan (Opsumit)
• Riociguat (Adempas)
• Selexipag (Uptravi)
• Sildenafil (Revatio)
• Tadalafil (Adcirca)
• Treprostinil (Orenitram, Remodulin, Tyvaso)

To make medications more affordable, Accredo may offer financial aid for copays. They claim to have provided $2.3 billion in copay assistance in 2022. Ask to speak with a copay assistance representative to see if you qualify.

2. Synergen Rx

Similar to Accredo, Synergen Rx is a specialty pharmacy that offers free delivery of PH and PAH meds and additional services like access to a pharmacist, refill reminders, and help in working with your insurance company.

Along with PH and PAH, Synergen Rx specializes in a handful of other diseases like hepatitis, multiple sclerosis, and osteoporosis. The company offers copay cards, grants, and financial assistance to help with medication costs.

3. Fairview Specialty Pharmacy

Fairview Specialty Pharmacy provides many of the same conveniences as other specialty pharmacies, including free prescription delivery and refill reminders. In addition, if you call the company with questions, someone who is qualified to help will answer right away, rather than putting you through a string of automated prompts.

Some PH and PAH therapies available through Fairview include ambrisentan and sildenafil.

4. CVS and Walgreens

Many traditional retail pharmacies also have specialty services for people with PH and PAH. For example, CVS Specialty can provide PAH therapies, including generics, that have been approved by the U.S. Food and Drug Administration (FDA). Trained pharmacists help screen for drug interactions and keep you updated on new treatment options.

Walgreens Alliance Rx is another specialty pharmacy with resources for people with rare conditions, including prescription home delivery and financial assistance.

5. Janssen CarePath

Janssen Pharmaceuticals manufactures some PH and PAH medications, including macitentan and selexipag. The company’s CarePath program is a free service to help people access these drugs.

CarePath isn’t a pharmacy but, rather, a resource to clarify your insurance coverage drug costs and find potential support in paying for your prescriptions. CarePath works much differently than a specialty pharmacy. Often, people with government prescription coverage (Medicaid, Medicare) are excluded from these types of programs.

Insights From myPHteam Members

Members of myPHteam have shared resources they use to help get their medication and cover prescription costs. One member explained:

“For assistance with your copay, you may want to contact organizations such as the Assistance Fund or Good Days. I am on several PH medications, and the Assistance Fund pays all that my insurance doesn’t cover — except for a low cost. My wife and I are both retired, and while our income is not six figures, it is close, and they help me with my high copays.”

Another member shared, “When my PH medication was initially ordered through my specialty pharmacy, and I was told the copay, I immediately contacted the prescribing physician’s office. With their assistance, I was able to obtain it through Cost Plus Drugs for much less per month, including shipping and handling.”

The member went on to explain, “When a different PH drug was prescribed to me a couple of months later, the coordinator with the specialty pharmacy contacted me and suggested that I apply to the Assistance Fund (TAF). I was fortunate to get copay assistance through them. TAF covers the copays for both of my medications, but the copays still apply to my annual out-of-pocket expenses. I will be hitting my maximum in the next couple of months, meaning my insurance will cover copays for the rest of the year. … The Pulmonary Hypertension Association also has people who can help.”

If you feel like you’re not getting the support you need from your health care provider and want to learn more about your treatment, combination therapies, and resources for PH and PAH, a specialty PH or PAH pharmacy can help bridge the gap. In addition, social support from myPHteam and other communities will help you feel less alone on the journey.

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 53,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Do you use an online pharmacy to order specialty medications to treat pulmonary hypertension? How about assistance programs to manage the cost of PAH treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.