Making Medicine Accessible
Clinics help patients get access to lifesaving prescription drugs
Ray* was ambivalent about his diagnosis. He had weathered an emergency colonoscopy when his doctor discovered that he had gastrointestinal bleeding and anemia. After feeling sick, and not knowing the cause of his illness, it was a relief to know what it was (Crohn’s disease) and an even greater comfort to know that there was medication to treat his condition. Ray was very much looking forward to feeling well again.
But when Ray went to fill his prescription, he learned that the pills would cost him $400 a month. Ray, like many others without insurance who cannot afford their medicine, found his hope for better health slipping away like the memory of a pleasant dream.
Fortunately, as a patient at the Bread of Healing Clinic, Ray was able to access the Community MedShare Prescription Assistance Project, which was funded by the Healthier Wisconsin Partnership Program (HWPP), a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin, in 2011 to help thousands of working and uninsured Milwaukee residents obtain free or low-cost medication.
Momentum for the project began when an informal collaboration of free and community clinics in Milwaukee began to cohere into a formal, chartered organization.
“HWPP came up as a funding option, and we had an academic partner, so everything was in place to expand our prescription assistance for patients,” Barbara Horner-Ibler, Medical Director of the Bread of Healing Clinic and the convener of the Free and Community Clinic Collaborative (FC3), said. “The project served as a focus for the energy and coordination of the newly organized FC3.”
Through the Community MedShare project, the collaborative trained staff and recruited volunteers from Marquette University and the University of Wisconsin-Milwaukee to help patients apply for Patient Assistance Programs, which are offered by pharmaceutical companies to increase access to patented medication.
“Most of the drug companies have these programs, and most of them are for patients at less than 200% of the federal poverty line who do not have insurance,” Horner-Ibler said. “They make medications available to those folks for free, but there is heavy paperwork involved. Once you are authorized, you are authorized for a year but have to reapply every three months.”
“And all companies use different forms. There is nothing universal about it,” Staci Young, Assistant Professor in the Department of Family and Community Medicine and the Institute for Health and Society, said. “Also, it is an additional burden for patients. Even though this is a great resource, patients have to find a way to get looped into it.”
In the case of diabetes, asthma, and other chronic diseases, it is important for patients to stay ‘looped’ into these programs over time in order to maintain a stable condition.
“People with diabetes and asthma, in particular,” Horner-Ibler said, “must have their medication or they’re in the hospital. Those are the options.”
Patient Assistance Programs, despite the administrative challenges, can be part of the solution for keeping these patients in their homes and at their jobs.
“While it’s a great idea for many patients, sitting down and completing the form every three months is a challenge,” Young said. “This project was a great opportunity for people to have assistance with the process at the various clinics.”
“And when patients have consistent medication, with consistent being the key word,” Horner-Ibler said, “they aren’t in the hospital, and they do much better.”
The Community MedShare Prescription Assistance Project demonstrates what it can mean for people to have reliable access to medication.
“All of the Free and Community Clinic Collaborative clinics have seen the value of being able to get consistent medications for patients, and most of them are now helping patients with Patient Assistance Program applications at some level,” Horner-Ibler said. “That has been a positive impact.”
The project also had a positive impact on Ray. The pharmaceutical company that invented his prescribed steroid had sold the drug to another corporation, which made the application process even more difficult than usual to navigate.
“It took investigation and effort, but we were able to get the medication, which was a lifesaver,” Horner-Ibler said. “He now has a normal blood count and he is back doing his two jobs.”
For Ray, and many others, fleeting dreams of wellness have been made real through reliable access to insulin, inhalers and other medicine that might otherwise be, like dreams too often are, just out of reach.
*Name altered to protect the patient’s privacy.