Making medication accessible

April 16-- Apr. 16--Last month, Eddie Basham paid about $100 for his Entresto, a heart medication.

When the Owensboro man filled his prescription this month, the price had more than doubled to $223 -- nearly the cost of his most recent utility bill.

In addition to heart issues, Basham also suffers from Type 2 diabetes and needs insulin. The price of that medication has skyrocketed by as much as 300 percent during the past two years.

In all, Basham, 64, takes 13 medications a day. He lives on a limited income from his pension and disability payments.

Although he has Medicare and supplemental insurance through Anthem, he paid between $1,500 to $2,000 a month out of pocket for medication when he fell into "the donut hole," a common term for a gap in Medicare prescription coverage during which the federal program stops paying and patients are responsible for the cost of their medicine.

With the high cost of specialty medications, Medicare enrollees with chronic health problems can rack up thousands of dollars annually in out-of-pocket costs, a recent Kaiser Family Foundation analysis found.

"I paid for it as long as I could, but I couldn't anymore," Basham said. "I had to do something."

Luckily, his brother told him about the Daviess County Community Access Project, which now provides Basham's insulin and another diabetes drug at no cost.

"They are a godsend," Basham said of employees at CAP.

In 2004, Daviess County Fiscal Court, Owensboro Health, Green River District Health Department and a group of concerned citizens joined forces to look for solutions to gaps in care. The health department took the lead and CAP was born.

CAP, which receives funding from the Daviess County Board of Health, Daviess Fiscal Court, OH and other grantors, works with pharmaceutical company programs that donate prescriptions to patients in need. Since its beginning in 2004, CAP has procured nearly $37 million in donated prescriptions -- at no cost to regional patients.

For every dollar invested in CAP, the community receives nearly $36 in donated prescriptions and services, said Suzanne Craig, the program's director.

"On average, every patient receives at least $2,396 in medications," Craig said.

Asthma, diabetes and heart-related medications are the program's most-requested drugs, she said. CAP has helped patients with multiple sclerosis receive prescriptions that cost $10,000 a month and more.

Basham is thankful for CAP's assistance. He doesn't know how he would manage without it.

"I knew the health department was down there, but I thought it was for other people -- not for me," he said. "You go in down there, and they're smiling. They greet you. They are there to help you. There's no attitude, no looking down their noses."

Craig said CAP's average patient is about 50 to 60 years old, but the program helps people of all ages who need ongoing medications. As far as income eligibility, there are more than 5,500 different programs with varying requirements. CAP officials navigate that complex system to provide assistance when possible.

Besides assisting with medications, CAP also refers patients to other community resources, provides appointment reminders and follow-ups, and enrolls patients who qualify in Medicaid, KCHIP and insurance subsidies through the Affordable Care Act plans.

For more information about CAP, all 270-852-2904.

Renee Beasley Jones, 270-228-2835, [email protected]

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