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Pharmacy, companies work for patient good by Dick Peterson Public Relations In the last fiscal year ending June 30, the pharmacy at McClennan-Banks outpatient clinic filled nearly 15,000 prescriptions for free. No bill sent; no payment received. That’s 14,706 free prescriptions out of the total 95,247 the pharmacy dispensed last year. And those free medications didn’t cost MUSC a cent. In fact, the pharmacy has chalked up more than a million dollars—$1,015,277, to be exact—in savings for the university thanks to the hard work of pharmacy employees and their negotiations with a few generous pharmaceutical companies. That’s just the savings the university can account for. Unknown are the costs that would have incurred had the medications not been given and patients without the means to pay for them had gone without— repeated emergency room visits or the cost of serious illnesses and hospitalizations.  “We have a fair number of patients who are unable to pay for prescriptions their doctors write,” said registered pharmacist Charlotte Johnson, McClennan-Banks Pharmacy coordinator. “Routinely, those patients or their doctors would have to apply directly to the pharmaceutical company for their medications. At the Medical Center, a dedicated team assists with this process.” The process would usually take from four to eight weeks, Johnson said. Also, MUSC has an alternative program that can discount a patient’s medication up to 60 percent. But as a result of negotiations with pharmaceutical companies, namely Bristol-Myers Squibb, Astra-Zeneca, and OrthoMcNeil, all that’s changed. It’s been good for the pharmacy, the patients and the drug companies. They’ve developed a system they call bulk replacement. With bulk replacement, MUSC buys bulk stock initially, screens the patients whose income level qualifies them for free medications and the pharmaceutical companies replace the stock without charge. Patients who qualify receive instant approval. “We don’t profit, but we don’t lose, either,” Johnson said. “We started this in July with three companies and have gone from filling virtually no prescriptions for free to more than 600 a month now.”  Johnson said that while the drug companies bear the cost of providing free medications, they are relieved of the burden of screening each patient to check qualifications. “We’ve always done that,” Johnson said. “Now the drug companies are leaving it up to us to qualify the patients.” In another move to provide free medicine for patients unable to pay, the drug companies offer substantial numbers of sample medications. “We gave away 9,713 sample prescriptions last fiscal year,” Johnson said. “That amounted to $526,324 in free medications that the pharmaceutical companies provided. You don’t hear that much about what the drug companies do to help people who can’t afford the medicines they need.” The bulk replacement program has saved MUSC $170,989 and the university has saved $279,660 from other free drug programs. Few know about the dedicated people in the McClennan-Banks pharmacy who “pound out the nuts and bolts of dispensing free medicine so a non-paying patient won’t be at the front door of the emergency room with an elevated blood sugar.” The “nuts and bolts” Johnson refers to certainly include the screenings, which are repeated every six months to be up-to-date with each patient’s situation, and it includes frequent calls to the doctors to authorize changes in the prescriptions they write. Johnson explained that in cutting costs to the pharmacy, each medication in stock was reviewed and evaluated to determine which could be eliminated to save money. So where there were a number of medicines of the same class, only one would be stocked. “We have to phone the physician who wrote the prescription each time we need to recommend a change. And we counsel the patient if they receive different medication or if it should be taken on a different schedule.”  Johnson added that “lifestyle medications” have also been eliminated. “We’re a different kind of pharmacy, for sure. “We have come under budget on drug purchases for the past few years, and each year’s budget is set to the lower level of the year before,” Johnson said. “I think we’ve proven that even with cutbacks you can manage better and still give quality care. “It’s not the pharmacy acting alone,” Johnson said. “Our team consists of a great group of patients, physicians, physician assistants, nurse practitioners, nurses, pharmacy personnel and the financial personnel to make the difference.”   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.