Related Guides on this Topic
You may also want to see this guide on a related topic: Medicare
Part D Prescription Drug Benefit
Introduction
Pharmacy services are an important part of the health care system,
but especially in rural communities. Rural areas tend to have an
older and more chronically ill population, with a greater need
for advice from a pharmacist on managing medications. Despite this
demand for services, rural pharmacies face many challenges to stay
open, including financial pressures and a lack of pharmacists to
provide services. Rural residents may also be unable to afford
prescription medications or unable to get transportation to the
nearest pharmacy. While the growth of Internet and mail-order pharmacies
might mistakenly suggest that geographical limits to access are
no longer a concern, rural pharmacies and pharmacists will continue
to fill an important and much-needed role in the health of rural
people.
Frequently Asked Questions
Tools
340B Prime Vendor Program
Web site
Service that negotiates pharmaceutical pricing below the 340B price and establishes distribution solutions and networks that improve access to affordable medications for participants of the 340B Drug Pricing Program.
ASHP/PSSC Patient Assistance Program (PAP) Resource Center
Web site
Information and resources to establish a patient assistance program (PAP) to increase medication access. Also includes links to state and manufacturer PAPs.
BenefitsCheckUpRX
Web site
Helps Medicare beneficiaries learn about and enroll in government benefits, including Medicare Part D, the new outpatient prescription drug benefit, and other federal, state and private programs that can help save money on health care and prescription drugs.
CMS Pharmaceutical, Pharmacy, & Device Manufacturers Open Door Forums
Technical assistance
Provides information on a series of CMS forums addressing pharmacy issues. Includes call-in instructions for the next call, how to register for the mailing list, and links to pharmacy-related fact sheets.
Cover the Uninsured: Resources for Individuals
Database
Lists resources and programs by state that can help individuals find health insurance, help paying for prescription medication, and related needs.
Help With Prescription Drug Costs
Web site
Helps Medicare beneficiaries that qualify apply for help with Medicare prescription drug costs.
HRSA Pharmacy Support Services Center
Web site
Information and resources related to the 340B prescription drug program, which requires drug manufacturers to provide outpatient drugs to eligible health care facilities at a reduced price. Includes information on program eligibility requirements, FAQs, and other information.
Insure Kids Now!
Web site
Information on free and low-cost health insurance programs for children.
Call toll-free at 877.543.7669.
KatrinaHealth.org
Web site
An online service to help individuals affected by Hurricane Katrina work with their health professionals to gain access to their electronic prescription medication records.
Med Solutions
Web site
Assists individuals in accessing Patient Assistance Programs (PAPs) that may help reduce prescription medication costs. The service fee may be waived for those with financial need.
Office of Pharmacy Affairs Pharmacy Technical Assistance
Technical assistance
Pharmacy technical assistance for 340B-eligible entities via a team of consultants. Toll-free: 1-866-PHARMTA.
Partnership for Prescription Assistance
Web site
Provides patients and providers with resources to help qualifying patients who lack prescription drug coverage gain access to low-cost medications. Provides access to more than 475 public and private patient assistance programs, including more than 180 programs offered by pharmaceutical companies.
Pharmaceutical Manufacturers Patient Assistance Programs (PAPs)
Web site
Links to websites that help patients enroll in drug manufacturer-sponsored PAPs. Also includes information on manufacturer-sponsored drug discount cards.
Rural Health Research: Pharmacy and prescription drugs
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of pharmacy and prescription drugs, produced by the Office of Rural Health Policy's funded rural health research centers.
RxAssist - Patient Assistance Programs
Database
Searchable database of patient assistance programs that provide free or low-cost prescription medications to people who cannot afford to buy their medicine. Includes information for patients and for health care providers. Free, but registration is required.
State Patient Assistance Program (PAP) Resource Sites
Web site
Links to state programs that provide Patient Assistance Programs (PAP) or support access to PAPs.
Together Rx Access
Web site
Free program that helps eligible individuals and families save money on prescription medications.
Funding
340B Drug Pricing Program
Allows certain facilities to purchase prescription and non-prescription medications at reduced cost
Award for Excellence in Medication-Use Safety
An award program to honor a pharmacist-led multidisciplinary team for its significant institution-wide system improvements relating to medication use.
Walgreen Community Grant Program
Funding for access to health and wellness, pharmacy education programs and mentoring initiatives, civic and community outreach and emergency and disaster relief.
Inactive Funding
Inactive Funding Opportunities -
Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.
Regulations, Forms & Other Useful Documents
340B Drug Pricing Program: Results of a Survey of Eligible but Non-Participating Rural Hospitals
Author(s): Andrea Radford, Rebecca Slifkin, Marianne Baernholdt, Claudia Schur, Karen Cheung
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Summarizes the results of a survey of pharmacy directors at rural hospitals eligible to participate in the 340B program but identified as not participating at the time of the survey. The purpose of this study was to understand why rural hospitals that are eligible for the program are not participating and to determine whether there are specific program features that present barriers to participation.
Date: 01 / 2007
340B Drug Pricing Program: Results of a Survey of Participating Hospitals
Author(s): Claudia Schur, Karen Cheung, Andrea Radford, Rebecca Slifkin, Marianne Baernholdt
Presents the results of a survey of pharmacy directors at rural hospitals currently buying discounted outpatient drugs through the 340B program. The purpose was to understand the perspectives of pharmacy directors on the 340B program in general, the financial impact of the program, and which specific program features presented barriers to its broader implementation. A joint paper from the NORC Walsh Center for Rural Health Analysis and North Carolina Rural Health Research & Policy Analysis Center.
Date: 05 / 2007
Access to Pharmaceuticals and Pharmacy Services in Rural Areas
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
Chapter from the 2006 Report to the Secretary: Rural Health and Human Service Issues. Discusses rural access to prescription drugs and pharmacy services, including affordability, utilization, and pharmacy workforce.
Date: 01 / 2006
Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports from the Field
Author(s): Andrea Radford, Rebecca Slifkin, Roslyn Fraser, Michelle Mason, Keith Mueller
The findings from this study, along with specific suggestions made by pharmacists during the interviews, suggest short-term actions that can be taken to address the challenges faced by rural independent pharmacies who are the sole providers in their communities. A joint publication of the North Carolina Rural Health Research & Policy Analysis Center and the RUPRI Center for Rural Health Policy Analysis.
Date: 11 / 2006
Medicare Drug Coverage under Medicare Part A, Part B, and Part D
Sponsoring organization: Centers for Medicare & Medicaid Services
Overview of drug coverage under Medicare Part A, Part B and Part D, with information on what drugs are covered under each part of the Medicare program.
Date: 08 / 2007
National ADAP Monitoring Project: Annual Report
Author(s): Alicia L. Carbaugh, Jennifer Kates, Beth Crutsinger-Perry, Britten Ginsburg, Murral C. Penner
Sponsoring organization: National Alliance of State and Territorial AIDS Directors
Detailed data on the state AIDS Drug Assistance Programs (ADAPs), a part of the Ryan White Program, that provides HIV medications to low-income people with HIV/AIDS who have limited or no prescription drug coverage.
Date: 04 / 2008
Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety
Author(s): Michelle M. Casey, Ira Moscovice, Gestur Davidson
Sponsoring organization: Upper Midwest Rural Health Research Center
Assesses the capacity of rural hospitals to implement medication safety practices. Found that many small rural hospitals have limited hours of on site pharmacist coverage. About three-quarters of the hospitals are using pharmacy computers, but a significant proportion either do not have a pharmacy computer or are not using it for clinical purposes. Hospital financial status is significantly related to pharmacist staffing, the use of technology, and implementation of medication safety practices.
Date: 12 / 2005
Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists
Sponsoring organization: Bureau of Health Professions
Describes the shortage of pharmacists, increasing demand for pharmacy services, and potential impact of the pharmacist shortage on patient care. Includes a section on demand for pharmacists in rural areas.
Date: 12 / 2000
Prescription Drug Safety Net: Access to Pharmaceuticals for the Uninsured
Author(s): Jack Hoadley
Sponsoring organization: National Health Policy Forum
Overview of organized programs that provide access to prescription drugs for the uninsured. Focuses on manufacturer-sponsored pharmacy assistance
programs (PAPs) and the federal 340B drug pricing program.
Date: 05 / 2007
Prescription Drug Trends
Sponsoring organization: Kaiser Family Foundation
Trend data for prescription drug coverage, expenditures, and the key factors that contribute to rising prescription spending: increases in utilization and prices, and changes in drug use from older drugs to newer higher-priced drugs.
Date: 05 / 2007
Reliance on Independently Owned Pharmacies in Rural America
Author(s): Michael D. Shambaugh-Miller, Nicole Vanosdel, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Policy brief providing locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. In over 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles. The information in this brief lays a foundation for analyzing vulnerability of pharmacy services in rural America and identifies the questions that research and policy activities should address. State maps show the locations of communities with only one pharmacy, independently owned.
Date: 11 / 2007
Review of the Relationship between Medicare Part D Payments to Local, Community Pharmacies and the Pharmacies' Drug Acquisition Costs
Author(s): Office of Inspector General
Sponsoring organization: U.S. Department of Health and Human Services
Analyzes the relationship between Medicare Part D payments, excluding dispensing fees, to local, community pharmacies and the pharmacies’ drug acquisition costs. Estimate Part D dispensing fees and compares them with Medicaid dispensing fees. Includes some data specific to rural pharmacies.
Date: 01 / 2008
Rural Hospitals and Telepharmacy
Author(s): Petra S. Berger
Sponsoring organization: Risk Management and Patient Safety Institute
Describes the implementation of the North Dakota state wide rural telepharmacy project. North Dakota became the first state to pass administrative rules allowing the practice of telepharmacy.
Date: 02 / 2006
Rural Hospitals' Experience with the 340B Drug Pricing Program
Author(s): Claudia Schur, Karen Cheung, Andrea Radford, Rebecca Slifkin
Policy brief describing the results of surveys of rural hospitals participating in the 340B drug pricing program and of rural eligible but non-participating hospitals. Includes information on factors affecting participation in the program and the benefits and challenges of participation.
Date: 09 / 2007
Telepharmacy Guide
Author(s): Charles D. Peterson, Howard C. Anderson, Jr.
Sponsoring organization: North Dakota Telepharmacy Project
Guidelines for pharmacists, rural communities, and others on how to successfully implement a telepharmacy program. Describes different types of telepharmacy services, regulatory issues, community needs assessment, and more.
Trends in Outpatient Prescription Drug Utilization and Expenditures, 1997 and 2004
Author(s): Marie N. Stagnitti
Sponsoring organization: Agency for Healthcare Research and Quality
Compares 1997 and 2004 estimates for the U.S. population on total expenditures, total number of purchases, average total expenditure, average out-of-pocket payment and average number of purchases for outpatient-prescribed medicines for those with a prescribed drug purchase. Also provides the percentage of total health care expenditures represented by prescribed drug expenditures for 1997 and 2004.
Date: 04 / 2007
Organizations
Office of Pharmacy Affairs
Federal government
Administers the 340 Drug Pricing Program, through which certain federally funded grantees and other safety net health care providers may purchase prescription medication at significantly reduced prices. A federal resource on pharmacy services. Part of the Health Resources and Services Administration.
Safety Net Hospitals for Pharmaceutical Access (SNHPA)
National organization
Works to increase the affordability and accessibility of pharmaceutical care for the underserved in this nation. An organization of approximately 400 public and private non-profit hospitals and health systems throughout the U.S. that participate in the Public Health Service 340B drug discount program.
Terms & Acronyms
340B Drug Pricing Program Program that allows qualified entities, such as FQHCs, to purchase prescription and non-prescription medications for their outpatients at reduced cost. Based on Section 340B of Public Law 102-585, the Veterans Health Care Act of 1992.
Computerized Provider Order Entry (CPOE) A system that includes both inpatient orders and the electronic ordering of outpatient prescriptions often referred to as e-prescribing. The CPOE allows physicians and other caregivers to input orders directly into a computer, thereby eliminating problems with handwriting legibility and order transcription.
Enrollment Period For Medicare Part D, those already on Medicare can enroll in the drug benefit between November 15 and December 31, and coverage would be effective on January 1 of the new year. If you were first eligible to enroll before May 15, 2006 but did not sign up, you may need to pay a late enrollment penalty.
Formulary A list of prescription drugs covered by a prescription plan.
Initial Enrollment Period For Medicare Part D, those already on Medicare could enroll in the drug benefit from Nov. 15, 2005 to May 15, 2006.
Late Enrollment Penalty A penalty applied to the monthly Part D premium if an eligible beneficiary enrolls in the Medicare drug benefit outside of the initial enrollment period or enrolls after a period of more than 63 days without equivalent coverage after they become eligible for Medicare.
Locum Tenens Someone who is available on a temporary basis to substitute for another member of the same profession.
Medicare Part D Prescription drug benefit added to Medicare in 2006. Created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
Medigap A Medicare supplement insurance policy sold by private insurance companies to fill gaps in Original Medicare Plan coverage.
Patient Assistance Program (PAP) Program to provide reduced-cost prescription medications to people with financial need. PAPs are typically sponsored by drug manufacturers and have specific eligibility requirements related to income.
PBM (Pharmacy Benefit Manager) Organization that administers and addresses cost containment issues for pharmacy benefits programs.
SCHIP (State Children's Health Insurance Program) A State and Federal partnership to help children without health insurance, many of whom come from working families with incomes too high to qualify for Medicaid but too low to afford private health insurance.
State Pharmaceutical Assistance Program (SPAP) State-sponsored program to provide reduced-cost prescription medications to people with financial need.
True Out-of-Pocket Costs (TrOOP) Drug costs paid by a Medicare enrollee, or on behalf of an enrollee by a family member, charitable organization, or State Pharmacy Assistance Program.
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