Skip to main content
SpringerLink
Log in

Controlling Pharmaceutical Costs in a Student-Run Free Clinic in a Resource-Limited Patient Setting

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Our institution’s student-run free clinic has been able to offer medication at no out-of-pocket cost to all patients since it opened in 2004. We have employed two strategies to manage prescription drug costs while simultaneously increasing medication coverage: (1) using Patient Drug Assistance Programs (PDAPs) and (2) developing an institutional-level partnership with pharmaceutical charities for medication subsidization. In this study, we aimed to analyze the financial impact of these measures on the clinic.

A query of clinic data over the past 5 years identified 299 active PDAPs, corresponding to 299 fully-subsidized prescriptions. In 2017, there were 35 active PDAPs, increasing to 52 (2018), 62 (2019), and 82 (2020) before a decline to 68 PDAPs in 2021. The company affiliated with the most PDAPs varied annually: GlaxoSmithKline (2017), Lilly (2018, 2019, 2020), and both GlaxoSmithKline and Lilly (2021). The most frequent medications were sitagliptin (2017), insulin (2018, 2019), albuterol (2017, 2018), and dulaglutide (2020, 2021).

In addition, data extracted from the private company subsidization program was analyzed for the year 2021. Program membership was $10,000 for institution-wide medication subsidization for all uninsured patients in the hospital system. In total, the clinic was able to acquire 220 medications with a 96% subsidy, corresponding to a direct clinic cost of $2,101.28. Comparatively, the market value of these medications was $52,401.51.

Utilization of free drug acquisition programs and partnerships with pharmaceutical charities allowed for an increase in cost-savings and medications provided. Although the process for applying for medication assistance programs is complex, these programs serve as powerful tools for providing medications that may otherwise be unavailable due to cost. Other clinics and healthcare settings with uninsured patients should consider these programs as a means to ease medication cost burden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

EHHOP:

East Harlem Health Outreach Partnership

GSK:

GlaxcoSmithKline

J&J:

Johnson and Johnson

NYC:

New York City

PDAP:

Patient Drug Assistance Program

References

  1. Donohue, J. M.et al., (2011). “Impact of Medicare Part D on antidepressant treatment, medication choice, and adherence among older adults with depression,“ Am J Geriatr Psychiatry, vol. 19, no. 12, pp. 989 – 97, Dec https://doi.org/10.1097/JGP.0b013e3182051a9b

  2. Piette, J. D., Wagner, T. H., Potter, M. B., & Schillinger, D. (Feb 2004). Health insurance status, cost-related medication underuse, and outcomes among diabetes patients in three systems of care. Medical Care, 42(2), 102–109. https://doi.org/10.1097/01.mlr.0000108742.26446.17

  3. Fernandez-Lazaro, C. I., Adams, D. P., Fernandez-Lazaro, D., Garcia-Gonzalez, J. M., Caballero-Garcia, A., & Miron-Canelo, J. A. (Jun 2019). Medication adherence and barriers among low-income, uninsured patients with multiple chronic conditions. Res Social Adm Pharm, 15(6), 744–753. https://doi.org/10.1016/j.sapharm.2018.09.006

  4. Choudhry, N. K. “Full coverage for preventive medications after myocardial infarction,“ N Engl J Med, vol. 365, no. 22, pp. 2088-97, Dec 1 2011, https://doi.org/10.1056/NEJMsa1107913

  5. Afendulis, C. C., He, Y., Zaslavsky, A. M., & Chernew, M. E. (Aug 2011). The impact of Medicare Part D on hospitalization rates. Health Services Research, 46(4), 1022–1038. https://doi.org/10.1111/j.1475-6773.2011.01244.x

  6. Hinterland, K., et al. (2018). Community health profiles 2018. Brooklyn Community District, 17, 1–20.

    Google Scholar 

  7. Jaya, B. “Containing Prescription Drug Costs at a Resource-Limited, Student-Run Clinic for the Uninsured,“ Journal of Student-Run Clinics, vol. 3, no. 1, 08/27 2017. [Online]. Available: https://journalsrc.org/index.php/jsrc/article/view/59

Download references

Acknowledgements

We would like to thank the Pharmacy Head of Mount Sinai, Susan Mashni.

Funding

None.

Author information

Author notes

  1. Celestine He and Roshini Kalagara contributed equally.

    Celestine He and Roshini Kalagara are co-first author.

Authors and Affiliations

  1. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Celestine He, Roshini Kalagara, Sumanth Chennareddy, Nina Rodriguez, Manasvinee Vahanan, Ayman Mohammad, David Skovran & Yasmin Meah

Authors
  1. Celestine He
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roshini Kalagara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sumanth Chennareddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nina Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manasvinee Vahanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ayman Mohammad
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David Skovran
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yasmin Meah
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sumanth Chennareddy.

Ethics declarations

Conflict of Interest

None.

IRB Approval Status

Not applicable.

Reprint Requests

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, C., Kalagara, R., Chennareddy, S. et al. Controlling Pharmaceutical Costs in a Student-Run Free Clinic in a Resource-Limited Patient Setting. J Community Health 48, 913–918 (2023). https://doi.org/10.1007/s10900-023-01232-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-023-01232-6

Keywords

Search

Navigation