January 22, 2021

by Emily Wicker 

“My husband died a month ago, so I don’t have health insurance and I can’t afford my medications.”

“My brother-in-law is visiting us from overseas. He had a stroke the week before he was supposed to travel back home. He doesn’t have health insurance and cannot afford his new medications.”

These were just two of the many conversations that I had with patients who were struggling to afford their medications during my Advanced Pharmacy Practice Experience at the Charitable Pharmacy of Central Ohio, an innovative charitable pharmacy serving the underserved in Columbus, Ohio.

The Need For Affordable Medications

In 2015 it was estimated that 15% of adults in Ohio could not afford their prescription drugs. Some patients may be uninsured or underinsured and unable to afford their medications. This can lead to hard decisions, such as the choice to pay for their medications, pay bills, or buy food. Other patients may try to stretch their medications by cutting them in half or only taking them when they feel like they need them. With increasing prescription drug costs and compounded job and insurance coverage losses due to COVID-19, the number of patients unable to afford their medications has undoubtedly increased.

Unfortunately, when patients cannot afford their medications and, therefore, do not take them as prescribed, the risk for serious health complications increases. For example, patients with type 2 diabetes who cannot afford their insulin will have uncontrolled blood sugar, which could ultimately lead to diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome requiring hospitalization. Similarly, patients with chronic obstructive pulmonary disease, or COPD, who cannot afford their inhalers are more likely to experience acute exacerbations of their symptoms, decreasing their quality of life and increasing their need for hospitalization. These complications ultimately increase healthcare costs through emergency room visits and hospital stays, and contribute to increased morbidity and mortality. Charitable pharmacies are one way to bridge the cost gap for certain patients.

The Role of Charitable Pharmacies

Charitable pharmacies seek to address medication access needs by providing medications to their patients for free or at significantly reduced costs. While each program has its own qualifications for patients to receive assistance, many programs provide help to patients with limited income and who are uninsured or underinsured. Since charitable pharmacies operate on limited budgets based on donations and grant funding, they have limited medication formularies. However, by working with patients and their prescribers, pharmacists can work to provide patients with the best options the charitable pharmacy can provide for them. Studies have found that by helping patients access their medications, charitable pharmacies have reduced hospital visits and healthcare insecurity in their patients.

Innovation Through Charity, Creativity, and Collaboration

However, charitable pharmacies can do far more than simply providing patients with medications. The Charitable Pharmacy of Central Ohio has found many innovative ways to holistically meet the needs of their patients. By measuring a patient’s blood pressure and blood sugar at each visit and recording it in an electronic health record, pharmacists are able to not only provide patients with their medications but monitor how effectively those medications are working. This allows for great conversations with the patients about their adherence, symptoms, and health goals, while also providing the pharmacist with the opportunity to discuss the patient’s needs with their doctors.

Unfortunately, when patients cannot afford their medications and, therefore, do not take them as prescribed, the risk for serious health complications increases.
Beyond medication therapy, many underserved patients have food or housing insecurity, that can negatively impact their health. For patients with diabetes and high blood pressure, their diet is another important part of their healthcare and disease management. However, many of the diet recommendations for patients are not only difficult but also too costly. To help combat food insecurity, the Charitable Pharmacy of Central Ohio has created “Farmacy in the City” a program to help connect patients with high blood pressure to resources for fresh produce, cooking classes, and meal planning ideas. In addition, a second pharmacy location will be opening in the spring of 2021 alongside a fresh food market. Together these initiatives help to provide patients with the resources they need to make and meet their health goals.

In addition, the Charitable Pharmacy of Central Ohio invests in preparing future pharmacists to implement similar solutions through residency training. The pharmacy residents gain skills and confidence as pharmacists while assisting with research and quality improvement projects that advance the pharmacy’s services. This year, Janessa Cohrs, a Cedarville University School of Pharmacy alumna, is one of the pharmacy residents at the Charitable Pharmacy of Central Ohio and has worked to develop curbside flu vaccine services and is researching the barriers to vaccinations in underserved patients.

By identifying the community and individual patient needs and finding creative solutions, charitable pharmacies innovatively serve the underserved holistically.

Emily Wicker is a current pharmacy student in the Cedarville University Doctor of Pharmacy Program. Emily completed her Bachelor of Sciences in Pharmaceutical Science at Cedarville and has worked as a Research Assistant for the Pharmacy Practice Department. Her professional interests include Ambulatory Care, Pediatrics, Internal Medicine, and Academia.

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