Online Program

Improving care for low-income, uninsured patients: A pilot to increase access to medicines through a replenishment program

Tuesday, November 5, 2013 : 5:30 p.m. - 5:50 p.m.

Paulina Ospina, MA, MHS, USA Programs, Direct Relief, Goleta, CA
Jen Lemberger, MPH, Research and Analysis, Direct Relief, Goleta, CA
In 2007, approximately 36.1 million adults in the U.S went without necessary prescription drugs because they could not afford them. People who are not in compliance with their prescribed medications have poorer health outcomes, and the most vulnerable – those with low incomes and without health insurance – face the greatest unmet need for prescription drugs.

Patient Assistance Programs (PAPs) provide prescription medicines to low-income, uninsured patients and are an essential element of the healthcare safety net. To access these PAPs on behalf of their patients, clinics must invest significant time and administrative functionality that is burdensome to staff. Separate PAP requirements create unintended barriers to access and delays in care.

Direct Relief established a pilot program as an alternative to traditional PAPs to increase access to healthcare and medicine for low-income, uninsured people receiving care at safety net clinics. Direct Relief's Replenishment Program:

• Increases access to medicines for low-income patients without health insurance; • Improves the way patients receive medications at clinics and health centers; • Streamlines the clinics' administrative processes spent on PAP enrollment and dispensing; • Maximizes efficiencies in providing donated medicines to patients; and • Provides a scalable platform for a national program accessible to additional pharmaceutical companies and recipient clinics.

The program works as follows: 1. The pharmaceutical manufacturers send donated medications to Direct Relief, in order to reach qualifying patients with their medications through eligible and vetted clinics. Direct Relief serves as a single entry point for the manufacturers wanting to provide access to medicine for low-income and uninsured patients 2. Direct Relief certifies clinics to participate in the program based on set eligibility criteria, and provide bottle-for-bottle replenishment of PAP medications based on utilization on behalf of the manufacturer. 3. In this centralized model of distribution, participating clinics receive bulk replenishment of multiple donated medications based on drug utilization reports. Direct Relief serves as the distributor and repository of drug utilization data.

Since inception, the Replenishment Program has achieved the following outcomes: provided no-cost medicine to over 8,000 people; dispensed over 45,000 prescriptions; expanded to 10 clinic partners; and partnered with 3 healthcare companies. In addition, time studies have demonstrated a time-savings in put-away time between Replenishment Program drug shipments (8 seconds/prescription) versus traditional PAP drug shipments (1 minute 43 seconds/prescription.

Learning Areas:

Administer health education strategies, interventions and programs

Learning Objectives:
Identify 2 barriers to accessing drug for low-income, uninsured patients receiving care at safety net clinics. List 2 benefits to patients and 2 benefits to safety net clinics in receiving donated drug through a replenishment program over traditional patient assistance programs (PAPs).

Keyword(s): Access to Care, Safety Net

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I joined Direct Relief in 2009 with prior work experience in the pharmaceutical industry and clinical research. My educational background is in public health with a Master of Health Science, and have worked with underserved populations in primary care clinics abroad and in Santa Barbara County’s clinic. I am responsible for the day-to-day operations of the Replenishment Program, and am the primary point of contact for partner clinics that are enrolled in the program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.