Imatinib is a daily medication for chronic myeloid leukemia. For one member, the copay had become the largest single line in a household budget that had no room left in it.
Her Savings Advocate reviewed the claim and found an alternative sourcing pathway through a Tier 1 international pharmacy. The medication was the same brand, made by the same manufacturer, at the same dose. Only the point of purchase changed.
Her cost dropped from about six thousand dollars a year to about one hundred dollars a month. She kept her treatment, and she kept her budget.
This is not an unusual outcome. It is what happens when someone is paid to look for the lowest cost rather than the highest margin. The pathway existed the whole time; the difference was having a person whose job was to find it.