MARP Program Helps N.C Clinics Find and Track Patients' Free Meds
by Candi Helseth
Laura Owens, Chief of Pharmacy Services, uses MARP software to find and track free prescription drugs for patients at the Carolina Family Health Centers in Wilson, N.C.In North Carolina, the Medication Access and Review Program (MARP) is easing providers’ headaches while helping patients access free prescription medications provided through the Patient Assistance Programs* (PAP) funded by American pharmaceutical companies.
PAP offers more than 2,500 brand name and generic medicines through 475 patient assistance programs in various states. These free or nearly free medications are available to uninsured and underinsured individuals who can’t afford the cost of their medications.
MARP, which was developed by the North Carolina Foundation for Advanced Health Programs, has created a software package that includes a database of more than 100 leading pharmaceutical firms. MARP software also houses patient eligibility requirements and other medical information, making it easier for providers to navigate the system, find the required medications for patients and then track chronic patients’ ongoing usage.
“We have about 142 clinics throughout North Carolina, mostly rural health, free or faith-based organizations, using this software package,” said Tom Tucker, MARP manager in the North Carolina Office of Rural Health and Community Care (ORHCC)
“It basically houses all the eligibility requirements for all pharmaceutical programs,” Tucker said. “One person keeps up a database that keeps everyone current. It’s really made working with the PAP program very efficient and easy for these clinics. We keep adding more clinics every year.”
In eastern North Carolina, three federally qualified community health centers (FQHCs) in Nash, Edgecomb and Wilson counties have been using MARP since it began as a pilot project in May 2003. Four years ago the FQHCs opened pharmacies in their centers. With the addition of 340B discounts, Laura Owens, the Carolina Family Health Centers Chief of Pharmacy Services, thought the medication assistance programs might go away. Instead, usage has continued to grow.
“Adding the 340B pharmacies definitely expanded what we can do for our patients because the shortcoming of PAP is that it misses a lot of acute conditions and doesn’t cover all drugs,” Owens said. “Expanding to 340B allowed us to have a multitude of drugs not covered (under PAP) and to include inexpensive generics, over the counter drugs and testing supplies. But it didn’t eliminate the need for medication assistance.”
MARP software is particularly valuable, she said, in helping pharmacists track and flag a multitude of patients. “Its message center reminds you when patients need a re-order, where things are in the process, and if the process is proceeding in a timely manner.”
When an uninsured or underinsured patient presents a prescription to a pharmacist, the pharmacist checks patient eligibility and drug availability on MARP. MARP decreases paperwork and improves patient safety, Tucker said. A coordinator enters patients’ demographics and income eligibility into the computer. It automatically generates a form that shows where the patient can get the necessary meds for free or at reduced cost. ORHCC also purchases drug interaction and medication allergy data from data banks to include in the software. When meds are ordered through the free sources, a drug interaction check is activated first, raising an alert if there could be potential problems for the patient.
MARP added 16,198 new patients last year and delivered $76,555,000 (average wholesale price) in free medications, Tucker said. As of September, 105,125 North Carolina patients were receiving prescription medications that they otherwise could not afford. Since the program began nearly five years ago, 461,884 North Carolina patients have received $295 million in free medications.
North Carolina ORHCC has provided the MARP software to two clinics in Ohio and Kentucky that are serving as beta test sites to determine if the software could be beneficial to other states.
For more information, visit the MARP website, or contact Tom Tucker, MARP Program Manager by phone: 919-733-2040, or email:tom.tucker@dhhs.nc.gov.
* Note: The name of the PAP program differs among pharmaceutical companies and organizations. It is also referred to as “Prescription Assistance Program(s),” “Patient Assistance Program” and “PAPs.” For more information on PAP, visit the ASHP/PSSC Patient Assistance Program (PAP) Resource Center.
AROUND THE COUNTRY
PharmAssist Program in Montana Helps Patients Manage Mail Order Medications
Katherine Hale, at right, a pharmacist and assistant professor at the University of Montana Skaggs School of Pharmacy, counsels a pharmacy student on using an Advair inhaler. The School of Pharmacy provides a free credentialing program for pharmacists to participate in PharmAssist.
As more patients purchase medications through mail order and Internet drug companies, they are less likely to be under the supervised care of a licensed pharmacist. The PharmAssist Program in Montana is working to address the potential problems that result. Approved by the Montana State Legislature and funded by tobacco tax revenues, PharmAssist provides citizens with a no-cost, in-depth consultation with licensed participating pharmacists. The program is open to all residents, regardless of age or income.
“The goal is to help people better manage drug regimens and medication costs by having a face-to-face consultation with a licensed pharmacist,” said Roger Citron, a pharmacist at the Montana Department of Public Health and Human Services and director of the state's PharmAssist program. “Most of the people who’ve sought assistance are taking four or more medications. They need help managing their disease state.”
The pharmacist arranges to meet with a referred patient in a private location that is comfortable for the patient. The pharmacist helps the patient understand how the prescribed medications may affect the body and whether any multiple medications are compatible and working effectively. The pharmacist also listens to the patient’s concerns and may suggest lifestyle changes that can contribute to better health.
“Consultations are authorized in advance and when it’s mutually agreeable—meeting in the client’s home can be ideal,” Citron said. “This may help the pharmacist learn additional valuable information, which can play a role in optimizing the client’s care.”
Eric Beyer and Gina McCarthy, who own and operate Frenchtown Drug in Frenchtown, Montana, provide Montana citizens with no-cost, in-depth consultations through the state's PharmAssist program.
To date, 27 pharmacists have become credentialed for PharmAssist through a free continuing-education program the University of Montana Skaggs School of Pharmacy in Missoula began offering two years ago. State funding pays the pharmacists for the time they spend with patients enrolled in PharmAssist, but not for travel. Citron said the reimbursement recognizes the value of pharmacists’ clinical skills and knowledge.
Citron said PharmAssist is still in early stages and pharmacists aren’t yet available in all rural areas. Participating pharmacies and physicians refer patients, and patients can also refer themselves. Any Montana resident who can benefit from a consultation is eligible to receive up to $200 in PharmAssist services per year. Citron said the Department of Health continues to enroll pharmacists, and the UM Skaggs School of Pharmacy is doing evaluations and collecting data to assess the program’s effectiveness.
For more information on PharmAssist, visit the Montana Department of Public Health and Human Services Prescription Assistance Programs web page (in the Montana PharmAssist Program section, click on one of the links, for Consumers, Participating Pharmacists or Pharmacists). Or, phone 866-913-2323 (toll Free in Montana) or 406-444-0440 (Helena/Out-of-State), or email Roger Citron at rcitron@mt.gov.
