More
than 46 million Americans under the age of 65 are uninsured.
Another 16 million are considered under-insured because, even
with insurance, they struggle financially to pay for needed
medical care.
While Medicare Part D has helped many seniors by providing prescription
drug coverage, there is a significant gap in the healthcare
system to provide individuals with affordable healthcare services
and prescription medications.
The cost for the uninsured is borne by all, through increased
taxes and higher cost of goods and services. For example, $1
out of every $12 spent on healthcare insurance premiums indirectly
pays for care provided to the uninsured. Additionally, the economy
loses up to $130 billion annually in productivity due to health
issues of the uninsured. Nearly 50 percent of all Americans
who file for bankruptcy do so because of medical expenses.
Making Prescription Drugs Affordable
for the Uninsured
Express Scripts Inc., located in Maryland Heights, Mo. and one
of the largest pharmacy benefit managers in America, knew their
expertise in managing the cost of medications for employers
could also be used to help the uninsured with the high cost
of medications. Rx OutreachSM, a patient assistance program,
was developed in 2004 as one of the first private-sector solutions
to help moderate income individuals afford generic medications.
This program works like the many patient assistance programs
for brand medications that are currently offered by pharmaceutical
manufacturers.
Rx OutreachSM is for individuals whose incomes are at or below
250 percent of the federal poverty level. Approximately two-thirds
of the uninsured would qualify for Rx OutreachSM based on their
family income so this program goes a long way in helping the
uninsured with the cost of prescription drugs. It provides access
to over 110 medications, predominately generics that are used
to treat a range of common chronic medical conditions like heart
disease, high cholesterol, diabetes, and depression. If an individual
qualifies for Rx OutreachSM, (s)he pays a small administrative
fee of $20 to $30 for each 90-day supply of medication. There
is no other cost to use the program. On average, an individual
can save $100 for a 90-day prescription compared to the normal
price of medications at retail pharmacies.
Local Companies Value Rx OutreachSM
Employers can provide Rx OutreachSM to employees that do not
qualify for benefits, such as part-time or seasonal workers.
Helping employees with the cost of their medications is a good
first step to reduce the gaps created by lack of insurance.
Rx OutreachSM already meets the needs of many businesses wanting
to improve the morale and health of employees without the high
cost associated with full healthcare benefits. Melanie Wilson,
who serves as director of human resources for Panera franchise
Breads of the World LLC, says, “We chose to offer this program
to our low-income associates because it gives them an avenue
to get low-cost medications; something that we believe they
would not have otherwise. In addition, the fact that there is
little to no administration on the part of the employer was
especially attractive.”
Since the launch of Rx OutreachSM two years ago, over 400,000
uninsured and underinsured people across the U.S. have been
able to get medications through the program. Rx OutreachSM serves
consumers in every state and Puerto Rico, and has a major presence
in Tennessee, Texas, Kentucky, Georgia and Ohio. To date, the
program has helped the uninsured save over $140 million.
George
Paz,
president and CEO, Express Scripts |
|
Rx OutreachSM is the only patient assistance program helping
uninsured and underinsured Americans save money by offering
generic drugs. “For decades, generic drugs have been proven
safe and effective. Today more than half of all prescriptions
are written for a generic drug,” says Express Scripts President
and CEO George Paz. “By offering the Rx OutreachSM program,
we further demonstrate our commitment to making the use of prescription
drugs safer and more affordable.”
Bonnie Filandrinos, president of Clayton-based Staffing Solutions,
sees the value of offering the program to her employees. “Temporary
workers are continually faced with the challenges presented
by unaffordable healthcare coverage. Rx OutreachSM offers a
solution to help temporary staffing agencies, and we are thrilled
to join with Express Scripts in providing the Rx OutreachSM
program to our employees as a resource for obtaining affordable
prescriptions medications that can help so many of our employees,”
says Filandrinos.
Patient Assistance Program Benefits
Employer and Employee
Rx OutreachSM may help companies retain their employees, avoid
the high cost of employee turnover, and reduce absenteeism.
Fast food restaurants, retail chains, hospitality and concession
services, and other types of businesses may have employees who
qualify for this program.
Rx OutreachSM can also be used in conjunction with limited benefit
programs, such as those with very high deductibles or out-of-pocket
costs. The only cost an employer would have in using Rx OutreachSM
is the cost associated with communicating the program to its
employees.
Businesses wanting more information about Rx OutreachSM should
contact Tina Jason, senior director at Express Scripts who oversees
the Rx OutreachSM program, by calling (314) 702-7810. “As more
attention is focused on the uninsured, employers are proactively
seeking ways to be part of the solution. Rx OutreachSM provides
an easy way for businesses to help without the high cost, in
terms of both dollars and administrative time,” says Jason.
Article sources include: www.pparx.org,
www.kff.org,
www.covertheuninsured.org,
www.americanprogress.org,
www.cmwf.org,
www.iom.edu.
