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Facilitating Quality, Cost-Effective Medication Access

A How-To Guide written by Marisa Mancuso Barnes of Free Clinic Solutions

For health care providers, diagnosing a disease is only one step toward helping the patient become healthy.  Being able to treat the condition adequately is another.   This is particularly true in free and charitable health care settings where uninsured and uninsured patients may lack the means to be able to buy the medications necessary for their care.

In 2011, Americares conducted a needs assessment of over 400 safety-net health clinics across the United States. Behind primary care physicians, a lack of affordable medications was the second leading resource constraint identified by clinics.

Studies have shown that up to one-third of individuals, both insured and uninsured, never fill the prescriptions given to them by their medical provider.  Cost is certainly a factor.  Retail prescription drug prices increased an average of 6.9% a year from 1997 to 2007, more than two and a half times the average annual inflation rate of 2.6% over the same period.2   Lack of access to critically needed health care and medications results in little or inconsistent medication compliance for the treatment of chronic illnesses, and medical conditions are thus exacerbated.  

Every day free clinics across the country face the challenge of providing access to affordable medications for their patients.  Many patients are on multiple medications, requiring the clinic to be agile, resourceful, and efficient in making them available.  A good medication access program typically contains multiple approaches to obtaining medications, with the end goal of providing free or low-cost medications to their uninsured and underinsured patients. 

The medication access guide available here is intended for free and charitable clinics, as well as health centers, that are looking to build or expand their medication access streams.  The guide describes proven methods and strategies for facilitating quality, cost-effective medication access in a charitable setting. 

Topics covered include:

  • Considerations before starting a medication access program
  • Patient assistance programs (PAP)
    • Future of patient assistance programs in the post-reform era
    • PAPs for generic medications
    • Resources required to effectively utilize PAPs
    • PAP software programs
  • Institutional patient assistance programs (IPAP)
    • The difference between a PAP and an IPAP for a free clinic
    • General IPAP contracts and requirements
  • On-site pharmacies
    • Resource requirements for an on-site pharmacy
    • Pharmacy licensure
    • Purchasing options for an on-site pharmacy
  • Development and maintenance of a drug formulary
  • Contracting with an outside pharmacy
  • Additional options for facilitating access to medications
  • Resources for Free or Low-Cost Diabetic Supplies

Two versions of the guide are available: a shorter version, comprised of brief, concise bulleted sections addressing the topics listed above, and a narrative version, which provides additional background and language.