Response to AHCPR on CERTs:

Shiloh Turner, The Health Foundation of Greater Cincinnati
November 10, 1998

This letter is in response to the Agency for Health Care Policy and Research's request for ideas and advice in implementing a new grant initiative that will improve the use of drug and biological therapies.

Recently, our community expressed interest in forming a pharmaceutical task force committee to tackle some of the difficult issues we face in obtaining and distributing medications to the poor and underserved population in Greater Cincinnati. This task force is comprised of a variety of members ranging from staff of local hospitals to grass-roots community health centers to pharmacists, etc. The general charge of the task force was to collect information at the community level regarding this problem and to then formulate community solutions. The committee sent a short survey to providers in our area.

To summarize the medications for the poor survey results, it was found that 63% of those surveyed were currently subsidizing medications for the poor. The dollar amount spent last year alone exceeded $3,400,000! The providers reported that some of the difficulties they experienced included the difficulty and time-consuming nature of applying through the individual pharmaceutical companies for discounted/free medications. Apparently, there is no standardization of forms for receiving discounted medications, and even if clinics do receive free or subsidized medications for individual patients, the renewal process is very cumbersome. Respondents also reported that many patients are receiving less-effective medications (if any at all) due the lack of affordability of the more effective medications. As a result, the poor patients are not receiving the level of care that they need. It also increases the amount of unnecessary care in the acute setting for these patients.

The Health Foundation of Greater Cincinnati is very interested in leading community efforts at improving the system for our service area. However, we are quite sure that we are not the only area of the country experiencing this challenge. I am contacting you to see whether the Agency for Health Care Policy and Research would be interested in further dialog regarding this topic, and whether your new grant initiative may include issues surrounding the difficulties of medications for the poor and underserved. I look forward to hearing from you.

Shiloh Turner
Health Data Analyst
The Health Foundation of Greater Cincinnati
One West Fourth St., Suite 512
Cincinnati, OH 45202
Telephone: (513) 241-1400, ext. 25
Fax: (513) 241-1418
sturner@healthfoundation.org

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