Pill Pushers 

With TennCare but a memory, many turn to industry assistance programs.

When the Help Is Here bus tour recently stopped by the Church Health Center, a crowd of patients sought their assistance.

"They were met by more people than they could possibly handle in a day," says Scott Morris, founder of the Church Health Center.

After TennCare reforms cut 190,000 enrollees from the program and put severe prescription limitations on many others, some uninsured patients have turned to the drug companies themselves for help.

The Help Is Here bus tour is part of an outreach program conducted by the Partnership for Prescription Assistance (PPA), a national coalition of pharmaceutical companies, physicians, and patient advocacy groups. The PPA acts as a sort of clearinghouse, offering patients and physicians access to 475 industry-programs they can utilize to fill their prescriptions. The bus is a traveling enrollment center where patients can find out if they are eligible for assistance.

The PPA began enrolling patients in April. During its first three months the program matched about 12,000 patients to eligible programs. As the TennCare reform date of August 1st drew near, enrollment numbers swelled considerably. In July, the monthly figure jumped to 24,273 and reached a peak of over 28,000 in August. Last month, about 15,000 more people were added, meaning PPA has matched over 82,000 Tennesseans to assistance programs since its inception.

Morris warns that patients "have to be pretty savvy to understand these forms. Most uninsured people in Memphis don't even know these programs exist." The complexity of the forms is worsened by the fact that each company requires a different form with entirely different criteria.

And the criteria needed to qualify for the programs can be quite demanding.

"The companies want to make sure you don't have any other options," says Morris. "They will ask a minimum-wage worker about his stocks and bonds."

Many of the programs require that participants have no health coverage at all, meaning people whose TennCare coverage has been reduced but not eliminated may be ineligible.

"If you're capped at five medicines, what happens when you have a sudden acute illness?" asks Morris.

Christian Chlymer, senior director with PPA, says the coalition offers service to both the uninsured and the underinsured. He also says that PPA has tried to make the eligibility forms less daunting by offering a one-stop site on the Internet.

"We didn't build this program in a bubble. We've been out there with patients, physicians, in clinics and with social workers, using their feedback to make this easier for folks," he says.

But growing demand has created new problems.

"Some companies have begun to subcontract this process out to smaller organizations, which of course makes the process take even longer," says Morris. And some private physicians, inundated with these forms, have begun to charge a fee for helping to process them.

Longview Heights resident June Fleming has no health coverage and uses an industry assistance program to obtain medication for her high blood pressure. On a recent morning, she sits in the waiting room of the Church Health Center in Midtown and says she considers the industry prescription assistance invaluable.

"Without these programs, there is no way I could afford the price of medicine. Even a regular doctor's appointment is too expensive," she says. "This is the best system Memphis has to offer."



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