One patient at a time
by Heather MurphyPublic Relations
Just another item on the lunch break to-do list, picking up a prescription is like running by the post office or dropping off the drycleaning.
Jan
Nguyen, third-year COP student, counts medication before dispensing to
a patient.
We don’t think twice about doing it.
But then again, that’s because many have the means to pay for that prescription.
In 1994, John Petit, Pharmacy Services, began the Prescription Assistance Program at MUSC with the idea of helping patients who needed medications but couldn't afford them. Since its inception, the program has helped more than 10,000 people receive medication for free.
These days, Petit works with two colleagues, Chimeca Mack and Jesse Wallace, to help as many indigent patients as possible get their meds.
Last year, they generated $1.5 million in reimbursements and helped 3,000 people.
After a social worker or financial counselor refers an indigent patient to the program, criteria are used to determine which of those patients are eligible to receive free medication.
“It’s not fair that we can’t give medicine to everyone who needs it,” Petit said. “But we had to come up with some sort of method. We try to help as many people as we can, and help those who need the most expensive medications (more than $50) first.”
What may sound like a simple concept turns into a complicated process.
The trio must ask a slew of questions about things like health insurance and income, and then categorize patients based on those answers.
At this point in the process, some patients may qualify for a pharmacy discount card based on income, to be used at McClennan-Banks Pharmacy, requiring patients come up with a 40 percent co-pay.
Other patients may qualify for a drug company’s assistance program, but the catch is this: each company’s program is different and thus requires different paperwork. What this means is more time on paperwork and less time helping people.
Another drawback with going directly to companies is the waiting period, sometimes as long as six weeks. However, some companies allow information to be read over the phone and will then qualify for 30 days worth of medication with the knowledge that they will be charged for it.
“There are patients who need drugs today and we do our best to make that happen. Before discharge, physicians want to know their indigent patients have access to high-cost medications,” Petit said.
MUSC also participates in bulk replacement, a program involving contracts with Bristol-Meyers Squibb, Astra-Zeneca, and OrthoMcNeil. These companies accept MUSC’s definition of indigent, as long as it’s documented, and send bulk issue medication based on monthly reports provided by MUSC.
This would be ideal for all drug companies to do, as opposed to the paperwork and application re-submissions that must be done for each patient every three months.
If every patient needing assistance went to a financial counselor and got a financial assistance plan on file, good for a year, things would flow easier within the overall program, according to the group. They spend an enormous amount of time trying to locate accurate and current patient information.
A final program called Communicare is a physician collaborative based out of Columbia.
Unique in that it only helps those disabled or employed, Petit and his colleagues cite it as a great way to go, given the cooperation and statewide coordination in helping indigent patients get their meds within two to three days.
“Because we’re one of Communicare’s largest customers, they’ve made quite a few provisions to accommodate us. We ask our physicians to try and prescribe medications that Communicare lists because of this,” Petit said.
But battling mountains of paperwork and re-submitting applications for re-approval every three months is nothing compared to what really frustrates the good work they do.
“Sometimes the patients we work with lack motivation and are uncooperative in getting accurate and current information to us in a timely manner,” he said. “These patients should care about doing the most they possibly can to get their medications but a lot of them don’t have the experience or resources. The patients who do what we ask get help first, it’s that simple. There’s just an overwhelming need out there.”
As if the above weren’t enough to deal with, Petit described a recent, although rare, situation. A man called in his need for medication and Petit filled out some of the paperwork over the phone, including his address on Oyster Rake Road on John’s Island. Thinking that the street name sounded familiar, Petit checked it out and it turned out that the address was on Kiawah Island, a very affluent community.
So with all the troubles and tribulations, why bother?
“There’s no denying that at times, you can feel pretty down about the current standing of things,” Petit said. “But then a man whose wife has a neurological disorder and whose daughter has cancer comes in and tells you how wonderful the program is and how much your work is appreciated. That makes it all worth it.”
There’s also a special lady in his life, the butter lady that is.
Receiving Petit’s help since 1994, the little old lady from rural South Carolina doesn’t have much, but every time she comes to see Petit she brings him some of her homemade butter.
“You have to treat everyone, including drug addicts, and then the butter lady comes in. We feel like we make a real contribution, so I can live with everything else,” he said.
No need to go to Webster’s Dictionary, that’s the definition of dedication.
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