PORTLAND, Ore. - With just a little help from a medication specialist to help get them started on the right track, low-income patients appear to do just as well at taking and benefiting from important prescription drugs as more affluent people with health insurance, a new study suggests.
The findings, published in the journal Pharmacotherapy, indicate that one of the real obstacles to better health care for the poor is not their unwillingness or inability to follow medication regimens, but a lack of understanding of available benefits and how to deal with the bureaucratic obstacles to obtain them.
"When we facilitate access to programs and help people understand their options, we found that indigent patients actually picked up their medication more than patients with health insurance," said Joel Marrs, an assistant professor in the College of Pharmacy at Oregon State University. "It was surprising how many people obtained and benefited from their medications."
The research, done in collaboration with the University of Colorado/Denver, studied 240 patients in Colorado with high cholesterol - a key risk factor for heart disease - who would benefit from use of a cholesterol-lowering drug. Some had health insurance, and others were eligible for health care subsidies under the Colorado Indigent Care Program. This program includes access to a medication assistance specialist who can help patients determine what prescription benefits they are eligible for, complete the necessary application forms and in many cases eliminate any delays in them getting necessary medications.
With that support system, a program to reduce LDL cholesterol was used by more than 90 percent of the indigent patients, a level that was actually 5 percent higher than the group who had health insurance. Success in reaching the lower cholesterol goal showed a trend toward a slightly higher rate in the insured group, 78 percent versus 69 percent.
"The successful treatment of high cholesterol in either of these groups was higher than the levels that are usually reported nationally," Marrs said. "These are important medications, and the results here are actually pretty encouraging."
Historically, Marrs said, there has been limited access to, or use of higher priced prescription drugs by low income people in the U.S. - adults receive only about 50 percent of recommended health care services, the report noted. However, some states now have assistance programs, and many drug companies have their own programs to help provide medications at low cost for people who are at or near the poverty level; 18 million prescriptions for lipid-lowering drugs were filled through this mechanism in 2003. And low-cost generic drugs are now becoming increasingly available from some discount pharmacies.
The biggest obstacle to better medication assistance for low-income people, the study suggests, may be knowledge about what programs exist and how to sign up for them.
"This study would indicate that medication assistant specialists are of real value in improving health care for low-income populations, but not everyone has a program like that available to them," Marrs said. "Alternatively, a good place to start would be your local pharmacist. They should be informed about some of the assistance programs that exist and be able to steer people in the right direction."
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