Medicare card may affect drug assistance program
Lynchburg News and Advance
Thursday, August 25, 2005After only nine months of providing a Medication Assistance Program (MAP) to its patients, the Johnson Health Center on Federal Street in Lynchburg made it possible to fill more than 4,000 prescriptions. “Right now, in nine months, we have 600 patients, and we’re adding 20 new patients a week,” said Robin Turner, the center’s patient assistance coordinator.
That’s about $1.13 million in retail costs in prescription drugs for chronic illnesses. Yet those drugs were free to the patients.
But in 2006, the arrival of the Medicare drug card may change the programs that have made a life-saving difference for many low-income people.
For those who use the drug companies’ indigent care programs, it’s time to start thinking about the Medicare drug card, even if answers aren’t on tap.
“Every medication assistance program in the country will be affected,” said Bob Barlow, executive director of the Free Clinic of Central Virginia on Main Street in Lynchburg.
The drug assistance programs are a significant resource to people who have no other options.
The Free Clinic’s long-running program, through MedsHelp as well as the clinic, served about 1,700 patients in 2004 and was able to get 25,000 prescriptions filled through the drug companies’ programs.
The Free Clinic makes calculations of drug costs savings based on the wholesale value of the drugs, and cites $1.5 million in drugs provided in 2004 to its patients.
The Free Clinic’s target patient group is the uninsured and the working poor. MedsHelp targets those who meet the drug companies’ criteria for free medications. The Johnson Health Center is a federally qualified health center that accepts those insured by Medicaid, Medicare or private insurance, or no insurance. Like MedsHelp, Johnson Health Center provides the MAP to the patients who qualify.
MedsHelp, started in the 1990s as a project of Interfaith Outreach Association, has evolved into the Community Prescription Program. It was housed for a period at the Johnson Center. After a brief trial run as a separate nonprofit corporation, under the auspices of the Pharmacy Access Coalition, it moved to the Free Clinic and is now merged into it.
Turner, who worked with the original program and as it evolved, now oversees MAP at the Johnson Health Center.
For those who have incomes of less than about $12,000 a year, the Medicare drug card will ask only a $1 co-pay for each prescription. A doctor will write the prescription and the patient will get it filled for $1, said Dr. Peter Houck, medical director of the Johnson Center.
But there aren’t many answers for others who are age 65 and on Medicare and whose incomes are more than $12,000 a year.
The new drug card is a result of the 2003 Medicare Modernization Act and an attempt to begin covering the cost of medications for senior citizens. The drug card benefit goes into effect in 2006.
For some low-income seniors, Medicare can offer a $600 credit toward prescription drugs.
“We don’t know what the policies are going to be,” said Barlow. “Many seniors will use up the $600 in two or three months. Then the question, can they go back to their old medical assistance program? We don’t know yet.”
Houck said one of the concerns is that people may throw away information from Social Security that’s now coming in the mail, perhaps because they’re already getting pharmacy assistance.
Don’t do that, said Houck. “It is extremely important.”
One Johnson Health Center patient and board member, Delia Hooks, has already applied for the card with Turner’s help.
She’s used the MAP program and says “it’s a blessing for people on low income.”
Patients who can’t get that help have to choose between medications and paying other bills.
Turner plans to continue to apply for the free prescription drugs for Medicare patients who need them through the pharmaceutical companies, until she is notified that she can’t.
Because Medicare discount drug cards from many companies will be out there, people on Medicare will have to select the one that best suits their needs.
Eventually there will be hundreds of drug company discount cards to choose from, Turner said.
“When these patients start getting a list to pick from, it’s going totally confusing to them so we’re going to try to narrow it down,” said Turner.
One way is to find the card that will cover the majority of drugs used by the patient, and the nearest pharmacy that signed up to participate. “All drug stores didn’t sign a contract with every card.”
In some cases, in order to use a card at a nearby drug store, the doctor may have to re-write a prescription for a drug available to the patient so it matches what the patient can obtain with the card.
Although it sounds complicated, so is the process of obtaining medications from the pharmaceutical companies’ indigent care program.
It takes about six weeks after an application to get the drugs, and the amount of personal information that is submitted is extensive, said Turner.
The Free Clinic has already held open informational sessions on the Medicare drug card benefit. Other local agencies that will be offering informational programs include the Central Virginia Area Agency on Aging.
Turner of the Johnson Health Center will help the center’s patients with questions they might have.
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