Resource Library

Volunteers in Health Care has asembled a variety of material for understanding the issues related to pharmaceutical access and uninsured or underinsured individuals. Included are those articles, government reports or foundation reports that VIH considers to be the most interesting of the information we regularly review. Additionally, we have included manuals and field reports produced by Volunteers in Health Care related to pharmaceutical access.

• Chronic Diseases
• Medicare/Medicaid Pharmaceutical Issues
• Pharmaceutical Access: General
• Pharmaceutical Access: PAPs, Samples
• Pharmaceutical Access: 340B Drug Discounts, Community Programs
• Uninsured/Underinsured
• How to Guides
• Field Reports on Starting A Pharmaceutical Program

Chronic Diseases

An Analysis of the Literature on Disease Management Programs

Callenges in improving care for high risk seniors in Medicare

Cost Related Medication Underuse: Do Patients with Chronic Illnesses Tell Their Doctors?

Falling Through The Cracks: Stories of How Health Insurance Can Fail People with Diabetes 

Which medical conditions account for the rise in medical spending?

Medicare/Medicaid Pharmaceutical Issues

Medicaid

Government Accountability Office:  Medicaid drug rebate program:  Inadequate oversight raises concerns about rebates paid to states

Office of the Inspector General:  Variation in state Medicaid drug prices

Medicare Part D

An in-depth examination of formularies and other features of Medicare Drug Plans

Coverage through the "doughnut hole" grows scarcer in 2007

Government Accountability Office:  Communications with Medicare beneficiaries on prescription drug benefits could be improved

Low income subsidies for the Medicare prescription drug benefit:  the impact of the asset test

Savings from the Medicare Drug benefit for beneficiaries with chronic conditions

The impact of enrollment in the Medicare prescription drug benefit on premiums

The Medicare Drug Benefit:  How good are the options?

Medicare Part D and Patient Assistance Programs

CMS statement regarding PAPs and Part D

Manufacturer Patient Assistance Programs:  Inside or outside Part D?

OIG Special Advisory Bulletin on Use of PAPs for Medicare Eligible Patients

OIG Advisory Opinion No. 06-03 (Schering-Plough)

OIG Advisory Opinion No. 06-04  (Caring Voice Coalition)

OIG Advisory Opinion No. 06-08 (WV Health Right)

OIG Advisory Opinion No. 06-09 (American Kidney Fund)

OIG Advisory Opinion No. 06-10 (Requestor undisclosed)

OIG Advisory Opinion No. 06-14 (Eli Lilly)

OIG Advisory Opinion No. 06-19E

OIG Advisory Opinion No. 06-21 (AstraZeneca)

Pharmaceutical Access: General

Effects of generics only drug coverage in a Medicare HMO

Follow the Pill:  Understanding the US commercial pharmaceutical supply chain

Federal Trade Commission statement regarding medication purchase for free clinics

Increasing the use of patient assistance programs

Physician strategies to reduce patients’ out of pocket prescription costs

Rx for affordability:  Helping patients with prescription costs

Uninsured Californians and access to prescription drugs

Physician communication about the cost and acquisition of newly prescribed medicine

Pharmaceutical Access: PAPs, Samples

Effect of a medication assistance program on clinical outcomes in patients with diabetes

Federal Drug Agency statement regarding the Prescription Drug Marketing

Act and donation of drug samples to free clinics

Patient assistance programs:  assessment of and use by safety net clinics

Pharmaceutical Access: 340B Drug Discounts, Community Programs

Establish 340B pharmacy services in a rural community health center

Uninsured/Underinsured

How much medical care do the uninsured use?

Insured but not protected:  How many adults are underinsured?

Threadbare:  Holes in America’s safety net

Who pays and how much?  The cost of caring for the uninsured

How to Guides

VIH Managing Medication Samples

Drug samples are regulated at both the federal and state levels. The main purpose of Managing Medication Samples is to provide guidance regarding the federal regulations, but information is also provided on how to learn more about your state regulations, and what questions to ask of your board of pharmacy or medicine. The manual also includes frequently asked questions and helpful hints.

VIH Starting a Pharmaceutical Access Program

The Staring a Pharmaceutical Access Program manual describes models communities have used to develop medication access programs, questions to consider when designing a program and key elements for putting a program in place. The manual includes sample formularies, web sites of interest, sample fee schedules and descriptions of fifteen programs across the country.

VIH Using Pharmacutical Company PAPs
Drug manufacturers provide free and reduced cost medications to eligible patients through charitable programs commonly known as patient assistance programs (PAPs). Locating information on these programs and navigating the application process can be complex and overwhelming. This guide is intended to serve as a reference for both individual prescribers and organizations that want to implement a system for using the patient assistance programs.

Field Reports on Starting A Pharmaceutical Program

Crisis Control Ministry, Forsyth County, NC
Crisis Control Ministry (CCM) is a nonprofit organization established in 1973 to provide emergency assistance to residents of Forsyth County, North Carolina who find themselves in serious financial crisis. Crisis Control Ministry provides assistance with rent, utilities, fuel, food and clothing and operates a pharmacy to provide free medication to eligible clients.

First Presbyterian Church Health Center, Kalamazoo, MI
The First Presbyterian Church Health Clinic in Kalamazoo, Michigan, is a volunteer-based, free clinic established in 1993 to provide urgent medical care to residents of Kalamazoo County who meet certain eligibility requirements. Through its Medication Assistance Program, the clinic supports community physicians by filling prescriptions at no cost or with a small co-pay for patients with chronic diseases who are unable to afford the medications they need.

St. Joseph's Health Center, South Bend, IN
The pharmacy at St. Joseph's is part of an indigent clinic operating as a department of a hospital. The clinic started out with three or four volunteer family practice physicians and quickly grew to over 70 physicians.

The Program for Pharmaceutical Care to Underserved Populations
(PPCUP), Pittsburgh, PA
The Program for Pharmaceutical Care to Underserved Populations (PPCUP) operates under the auspices of the University of Pittsburgh School of Pharmacy. Established in 1995, the program links volunteer pharmacists and students with three organizations providing primary health care to homeless and low-income individuals in the city. Through the participation of the School of Pharmacy, pharmacists, and pharmacy students, the PPCUP stores medication for its organizational partners; sends pharmacists and pharmacy students to join volunteer medical staff as they provide health care at shelters and drop-in centers; and works with partner organizations to support cost-effective prescribing.

West Virginia Health Right, Charleston, WV
WV Health Right, established in 1982 is a free clinic serving the uninsured and underinsured in Charleston, WV. As part of its commitment to health care, the clinic provides medication for free, both to its patients and to individuals referred by physicians in the Charleston area. The clinic's pharmaceutical access program enjoys support from local pharmacists, physicians, hospitals and the City of Charleston.