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Published Online: 4 April 2003

Nothing Is Free

According to the Web site www.needymeds.com, 179 pharmaceutical companies offer patient assistance programs (PAP), which are designed to provide free or low-cost medication to persons who meet income eligibility requirements. John Boronow, M.D., medical director of adult services at Sheppard Pratt Hospital in Baltimore, described problems with PAP and other options for obtaining medication for low-income people.
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Use the appropriate PAP: Paperwork is required for each drug, both from the doctor and the patient. Time pressures to see patients quickly, coupled with the fact that many of them are disorganized and passive, make this process very difficult for more than one prescription. An army of case workers is needed just to keep track of the paperwork in a high-volume practice with patients in need of multiple medications.
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Obtain samples from the pharmaceutical representative: The Joint Commission on Accreditation of Healthcare Organizations requires records of “quarterly expiration date checks,” a log of the lot numbers of every sample dispersed, and a locked cabinet. While these requirements are reasonable, they are administratively burdensome.
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Ask the pharmaceutical representative to bring a special supply of a sample for just one patient: This process becomes time consuming because doctors need to do it repeatedly.
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Use a clearinghouse, such as Medbank of Maryland, which can sometimes arrange one-stop shopping: Time is still a problem for the doctor.
The bottom line, added Boronow, is that all these options require considerable time from the doctor or staff and are virtually impossible to carry out for a high volume of patients over a long period.

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Published online: 4 April 2003
Published in print: April 4, 2003

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