Healthcare expenditure in the country has demonstrated an unsustainable growth rate over the years with increased spending on managing chronic diseases. The increasing morbidity and mortality rates from chronic diseases are one of the most pressing global public health problems, especially in low- and middle-income countries (Ding et al., 2021). The management of chronic diseases is further complicated by the lack of chronic solid disease management paradigms and readily available medication in primary healthcare (Ding et al., 2021). The problem of high costs of managing chronic diseases is felt significantly by individuals with chronic diseases who have to pay out-of-pocket to access suboptimal healthcare with minimal access to medication for their diseases (Ding et al., 2021). Their plight is worsened by the increased likelihood of developing disease complications such as diabetes, foot, and hypertension crises with major cardiovascular events like stroke and heart attack, requiring specialist visits (Ding et al., 2021). Therefore, this paper will enumerate and assess various strategies that could be used to address the issue of medication access for chronic disease patients who lack prescription coverage.
Medication utilization programs propose adopting evidence-based and cost-effective strategies to help increase the target population’s access to medication(Whitfield et al., 2021). The goals that the initiative should demonstrate to deliver quality use of medication include safety, to avoid causing harm to the patients, efficiency, patient-centeredness, timeliness by reducing waiting time, and equitability to ensure just or fair distribution of resources to all who use the program (Whitfield et al., 2021). The various strategies that meet these goals in ensuring ease of access to and quality of use of medication for chronic disease patients with no insurance include the referral of patients to financial medication assistance programs and chronic disease associations and offering adequate patient education in the management of chronic diseases in the medical-surgical unit. There are rising incidence and prevalence rates of financial medication assistance programs or pharmacy services that help patients access such payment programs for their medications (Hung et al., 2021). The most common financial medication assistance programs are patient assistance programs, coupons or copayment cards, vouchers, and discount cards (Hung et al., 2021). The patient using these services can access medication for free using assistance programs or at a reduced cost using other methods like vouchers and discount cards. Financial medication assistance is one of the cost-effective measures that has resulted in higher mean medication possession rates among members of these programs as opposed to those who do not utilize these services (Hung et al., 2021). Also, on financial medication assistance programs, the rate of patients who discontinue medication was 7% lower than those who do not utilize these services to access medication for their cardiovascular diseases (Hung et al., 2021). Therefore, financial medication assistance programs effectively increase patients’ access to medication.
Lastly, the healthcare provider is critical in determining prescription costs for individual patients. The healthcare provider is well-positioned to analyze the patient’s health needs versus their financial ability to meet their healthcare needs. Consequently, the healthcare provider could help the patient prioritize their healthcare needs to address the most pressing needs by utilizing the patient’s available funds and deferring other non-essential healthcare services to a later date. In planning the patient’s care plan, the healthcare provider could assess for the most cost-effective measure that would provide similar results instead of utilizing the most expensive diagnostic and treatment options that jeopardize the patient’s financial freedom. Therefore, the healthcare provider could help save the patient’s finances, especially when paying out-of-pocket, by helping with the selection of cost-effective programs and treatment options, such as referring patients to financial medication assistance programs.
References
Ding, H., Chen, Y., Yu, M., Zhong, J., Hu, R., Chen, X., Wang, C., Xie, K., & Eggleston, K. (2021). The effects of chronic disease management in primary health care: Evidence from rural China. Journal of Health Economics, 80(102539). https://www.sciencedirect.com/science/article/pii/S0167629621001247
Hung, A., Blalock, V. D., Miller, J., McDermott, J., Wessler, H., Oakes, M. M., Reed, D. S., Bosworth, B. H., & Zullig, L. L. (2021). Impact of financial medication assistance on medication adherence: A systematic review. Journal of Managed Care & Specialty Pharmacy, 27(7). https://doi.org/10.18553%2Fjmcp.2021.27.7.924
Whitfield, K., Coombes, I., Denaro, C., & Donovan, P. (2021). Medication utilization program, quality improvement and research pharmacist – Implementation strategies and preliminary findings. Pharmacy, 9(4), 182. https://doi.org/10.3390%2Fpharmacy9040182
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