Full Project Name:Community MedShare Prescription Assistance ProjectPrimary Community Organization:Bread of Healing Clinic, Inc.Primary Academic Partner:Staci Young, PhD, Family and Community MedicineAward Amount:$200,000Project Duration:30 months
Project Description Narrative:
Both the connection to health care and its affordability have worsened for many adults living with chronic health conditions. Specifically, uninsured individuals with chronic diseases frequently do not have access, because of financial hardship and the high cost of pharmaceuticals, to the required medications needed to control their conditions and avoid costly and debilitating complications. A retrospective study of adults with chronic illness, reported in DiabetesCare in 2005, indicated that 78% of patients whose incomes fall under 400% of the Federal Poverty Level and who subsequently report cost-related medication programs, are consistenly under-using prescribed medication. This translates into millions of Americans who cut back on their medication every month because of cost — and translates into increased costs and burden upon the health care system. A $1 increase in pharmaceutical expenditure is associated with a $3.65 reduction in hospital care expenditure.
While many pharmaceutical companies sponsor patient assistance programs (PAP), the challenge for patients and clinics are the myriad drug companies (500 nationwide) that each offer select medications and each have their own application process and eligibility criteria, resulting in a process that can be confusing, complex, and ultimately prevent patients from receiving and benefitting from medications. In addition, many free clinics are small and lack the human capital to assist patients in filling out PAP forms or maintain the processes related to the submission, receipt, refill, or renewal of completed applications — nor do they have the storage capacity to keep medications on site.
Milwaukee's Bread of Healing Clinic (BOHC) identified access to medication as critical to the ability to control the chronic medical problems presented by uninsured patients, specifically uncontrolled hypertension and diabetes. In 2007, BOHC expanded its medication access program to incorporate pharmaceutical companies' PAPs. Through this award, partners will pilot an expansion of the clinic's Community MedShare PAP program to include all three BOHC locations and five other free clinics in Milwaukee to increase the capacity of free clinics to be more of a safety net for Milwaukee's uninsured. The project will aim to increase access to free or low-cost medications for more than 10,000 working and uninsured individuals in Milwaukee through targeted activities including the use of trained volunteers.
Greater Milwaukee Free Clinic, Marquette Women & Children's Clinic, Medical College of Wisconsin Saturday Clinic for the Uninsured, Salvation Army Homeless Clinic, The Free and Community Clinic Collaborative, University of Wisconsin-Milwaukee House of Peace Community Nursing Center
Outcomes & Lessons Learned:
• Expanded access to medications for target populations, implementing the Community MedShare Prescription Assistance Project at six clinics in the greater Milwaukee area, with 6,546 patients receiving access to medications through the project. In addition to medications received through the PAP project, $3.5 million in medications were given to 15 clinics in the Milwaukee Free and Community Clinic Collaborative through the Community MedShare
• Continued to develop and strengthen partnerships with other clinics, federally qualified health centers (FQHCs), and hospital-affiliated organizations, engaging partners in discussions around best practices and building relationships for future collaboration and advocacy
• Implemented data collection efforts regarding medications applied for and received, which PAPs were easiest to access, number of patients served, and amount of medication received, analyzing data to assist partners in developing processes for clinic settings to successfully enroll patients into the program and track medication receipt, storage, and pickup
• Evaluated and documented barriers in implementing tracking systems at participating clinics, researching tracking systems and working with participating clinis to ensure that systems are community and culturally appropriate
• Conducted focus group with volunteers who dedicated 200 volunteers hours to the project at various clinic sites. Focus group findings documented favorable feedback on the program among volunteer students noting their participation helped them appreciate barriers patients face in accessing health care resources as well as the necessity for such programs to improve patient medication access
• Routinely brought project updates and data to the Milwaukee Free and Community Clinic Collaborative to inform and engage partners, and partnered with the Milwaukee Health Care Partnership to work toward expanding access to medications for uninsured residents citywide