Pharmacists Play a Key Role in Helping Underserved Patients

Knowing how to leverage resources can get medication into patients’ hands.

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Medication access is a key component for ensuring appropriate healthcare for all patient populations, but can be especially challenging for underserved patients who may not have convenient access to a pharmacy, be able to afford prescribed medications, or know how to navigate discount programs designed to help them obtain the medications they need.

This is where pharmacists can make a difference and was the topic of Sunday’s session, “Serving the Underserved: Exploring Your Resources,” which included a presentation of available resources as well as case scenario activities and a Q&A period.

Pharmacists have a challenging role when it comes to ensuring that all patients have access to medication, especially because the underserved population is so big and stretches across the U.S., according to Anne Misher, patient health support pharmacist for Caromont Health in Gastonia, North Carolina,

“The Health Resources and Services Administration describes the medically underserved as areas or populations designated as having too few primary care providers, high infant mortality, high poverty, or a high elderly population,” Misher said. “Quite a bit of our country is listed as underserved. It’s a problem that happens across our country and every state is impacted in some way.”

For rural areas, lack of transportation can be a primary indicator for being underserved, and although rural areas make up a large percentage of the underserved segment, even urban areas can be marked as underserved due to their proximity to care despite having more transportation options, Misher said.

“Not only does a medication have to be cost effective, it has to be available to a patient,” she said. “So sometimes we worry about the costs but other times we worry about them being able to get there to get the medication.”

Transportation and costs are only two of the barriers to medication access. Other barriers include:

  • Healthcare coverage and stability
  • Social inequities
  • Generational differences
  • Technology adoption and availability

Many people lost work status during COVID-19, which meant also losing their healthcare coverage, Misher said. Changes in work status have affected different patient populations in different ways, so there is an even bigger emphasis on working to ensure equity and that all patients have access to care.

Generational differences affect both elderly populations as well as very young populations. “When we think about generational differences, we can think about our elderly populations not having the ability to navigate prescription programs … or navigate the requirements when applying for assistance. For younger generations it’s about understanding their resources,” Misher said.

Age is also often a factor for technology adoption and availability, which is about the way patient populations adapt to technology. One shouldn’t assume, however, that young populations have the technology part mastered and elderly populations do not. “An elderly patient may engage in technology quite well while a younger patient may not have access to technology even though they are a younger age,” she said.

Resources available to assist with medication access for underserved patient populations include discount drug lists, patient assistance programs, donation dispensaries, and manufacturer samples.

Retail discount medications include generic medications that list for $4 and $9 and are relatively lower cost than branded medications. This can be a good option for some patients, but pharmacists should keep in mind that even though these costs are lower, it’s all relative. “That may still be expensive for patients, especially if they are on several monthly medications.”  Misher said.

Nonprofit or discount pharmacies include RxOutreach, Good Pill, and Blink Health and offer medications at a discounted price. They may only charge for the dispensing of the drugs. Discount coupons, such as GoodRx, RxSaver, NeedyMeds, and specific manufacturer coupons are also an option for patients who need more affordable medication options.

For each of these programs, pharmacists must consider if the patient can logistically get to the location to procure the medication, Misher said. They also must educate patients on the drug class of their medications because discounts can frequently change among medication brands. Also, chasing the lowest prices on medications can mean that patients are bouncing from pharmacy to pharmacy, which can make it difficult for pharmacists to catch potential drug interactions and impedes comprehensive medication management.

NeedyMeds is an especially helpful tool, she added. It allows users to search by drug name for a list of available resources, including patient assistance, discounted generics, links for coupons, support pages, drug videos, and drug information.

For Medicare patients, is a useful resource. “It’s like a Medicare version of NeedyMeds,” Misher said. “There is also a state pharmacy assistance program search option, as well. It can help you navigate on the state level as to what may be available for your patient in your given area.”

Manufacturer medication assistance programs are also a good resource for finding affordable medication options, but programs vary. For these programs, patients often must meet income level requirements based on the Federal Poverty Level.

“Sometimes they look for an income level that is 400% of the poverty line. Sometimes it is 200% of the poverty line, it just depends on the medication,” Misher said. This isn’t necessarily true for all programs. Some programs have been expanded to include those who cannot afford their medications. “We encourage patients to apply to see if they would qualify even if they have insurance, especially Medicare patients.”

One of the biggest roles a pharmacist can play in helping serve the underserved is simply through medication selection.

“Some manufacturers require different criteria for different medications,” Misher said, “so we can select within a drug class. So maybe think outside the box to find a drug that would work that is within the same drug class.”

Medication donation programs can also be useful. Examples of these include Direct Relief, Americares, Dispensary of Hope, PAN Foundation, and local community programs. Just make sure to be aware the inventory varies and that these drugs often have early expiration dates, she said.

Above all else, communicate with your patients, Misher said. “Communication is a big piece. Make sure to follow up and that your patients don’t have any questions. Help them understand the process.”