Institutional practices for charitable medication access for uninsured patients

Area of Science:

• Health Services Research
• Pharmacy Practice
• Health Economics

Background:

• Academic medical centers serve diverse patient populations, including those utilizing charitable care programs.
• Understanding medication prescribing and dispensing patterns is crucial for optimizing patient care and resource allocation.
• Charitable care programs aim to reduce financial barriers to healthcare access for vulnerable populations.

Purpose of the Study:

• To identify frequently prescribed medications within a charitable care program.
• To determine prescription fulfillment locations (in-house vs. external pharmacies).
• To assess the utilization and cost of charitable care program coverage for medications.

Main Methods:

• Retrospective cohort study utilizing electronic health records and pharmacy dispensing data.
• Analysis of 8453 prescriptions from 511 patients enrolled in a charitable care program (March 2019 - June 2021).
• Descriptive statistics to characterize medication, fulfillment location, and cost data.

Main Results:

• Cardiovascular disease, diabetes, and pain management medications were most frequently prescribed.
• Over 50% of prescriptions were filled at external pharmacies; 47% were filled at the medical center's outpatient pharmacies.
• The charitable care program covered 44% of prescriptions filled internally, assisting 148 patients at a cost of $111,052.

Conclusions:

• Characterization of patient demographics, medication use, and costs provides valuable insights for charitable care programs.
• Findings can inform the development of a charitable medication formulary to improve care quality and reduce costs.
• Optimizing prescription fulfillment strategies within charitable care programs is essential for patient access and cost-effectiveness.