More than 4,000 patients receive life-saving medications and other services through Alameda Health System’s leveraging of the federal 340B program, which provides free or significantly reduced price drugs.
340B requires pharmaceutical companies to give discounts to hospitals and clinics that serve high volumes of low-income patients. As a result, AHS saves about $15 million a year in medication discounts. These savings are then funneled through the system to help fund other endeavors at AHS, including the discharge medication program and the pharmacy program at the Adult Immunology Clinic (AIC).
“At Highland we often treat the sickest of the sick and the poorest of the poor. When many of our patients are discharged, they have been prescribed 8-12 different medications. We now provide them with a free 30 day supply of prescriptions from our outpatient pharmacy once they leave,” said Douglas Del Paggio, PharmD, pharmacy director for Alameda Health System-Highland Hospital. “Before this program was created, staff found that many patients had been readmitted or utilized the emergency department because they faced significant barriers to getting their medicine. Our patients face many issues including lack of transportation to a pharmacy and lack of funds to purchase their meds.”
Del Paggio estimates about 300 patients are discharged from Highland Hospital each month and that about $300,000 a year is spent on the discharge medication program. Additionally, for high costing mediation, the pharmacy staff works with the Drug Companies free drug programs to initiate the required applications so that the patients can continue to receive their medication. With over 20 years of experience in the pharmacy field, he states he has personally never heard of any other hospital offering this type of integrated discharge prescription assistance program.
Most healthcare providers only give patients three days’ worth of medicine when they leave. Having a 30 day supply of medication helps reduce readmission rates which is best for patient and provider.
“One bottle of medication can range anywhere from $2,000-$4,000 a month,” said Yolanda Dickey, PharmD, clinical pharmacist specialist at the Highland Hospital Adult Immunology Clinic (AIC), which provides services to patients who are HIV positive. “We fill prescriptions for almost 400 HIV patients. Currently, around 200 receive help from the AIDS drug assistance program (ADAP) to help cover the cost of medications.” ADAP is also 340B eligible.
In addition, the savings from 340B allows the AIC to offer medication delivery Monday-Friday to many patients who have difficulty with transportation. It also helps Dickey and her staff maneuver around the prior authorization (PA) issue to give out medicine. PA requires that pharmacies receive approval from insurers before filling prescriptions, which can result in unnecessary delays. According to the American Academy of HIV Medicine this is a serious growing issue for both HIV patients and providers because without treatment this can trigger a viral resistance and once this happens the medication is considered ineffective.
“Without these meds our patients face the risk of hospitalizations, opportunistic infections and the potential to infect others if their viral load isn’t suppressed. It would be a real public health issue,” said Dickey. “Patients come to me on a daily basis and tell me they can’t even afford their copayment. I’m glad we are able to offer them help.”