For the uninsured and underinsured, paying for medications can be as much of a challenge as finding an affordable health-care provider. Fortunately, a number of organizations and programs offer cheap or free drugs to those who qualify. Here's a roundup of some key local sources for discounted meds. (And if you know of one we missed, please send the pertinent info to firstname.lastname@example.org so we can add it to the online version of this article.)
The $4 fix
Though this isn't exclusive to Western North Carolina, numerous local health-care practitioners Xpress contacted stressed that when it comes to bargain prices on prescription medicines, the nation's largest discount retailer can be hard to beat. In 2006, Wal-Mart introduced its $4 prescriptions program, which has grown to cover hundreds of common prescription drugs (usually generic versions). Most medications on the list cost $4 for a 30-day supply at commonly prescribed dosages ($10 for a 90-day supply).
"I would advise everyone to always ask their doctor to prescribe a generic whenever possible — to get those $4 and $10 rates," says pharmacist Stephanie Kiser, the director of community health and corporate wellness at Mission Hospital. "Most things can be treated with generics," she adds, noting such exceptions as some diabetes drugs. Kiser also advises low-income patients to look into the assistance programs run by the major drug manufacturers.
Some other retailers — including Ingles, Target and Walgreens — have since followed Wal-Mart's lead, establishing similar programs.
To view Wal-Mart's current $4 list, go to any of the chain's pharmacies, or visit www.walmart.com/4prescriptions. To find out about manufacturers' programs, go to www.pharma.org and www.needymeds.org.
Buncombe County rolled out a discount-drug program in 2005, christening it BuncombeCountyRx. Sponsored by the National Association of Counties, the program is available to any Buncombe County resident regardless of age, financial status or whether or not you're insured.
Getting started could hardly be easier: Simply pick up your free card at any Buncombe County departmental office or branch library. You can start using the card right away at any participating pharmacy (there are about 50 in Buncombe and thousands more across the country).
"There is no enrollment form, no membership fee and no restrictions or limits on frequency of use," the county Web site notes. "Savings range from 13 to 35 percent on purchase of drugs at local pharmacies and up to 50 percent on mail-order purchases."
To locate a participating pharmacy, call (877) 321-2652 or visit naco.advancerx.com.
ABCCM's medication assistance program
In addition to its clinic (see "We Care" elsewhere in this issue), the Asheville Buncombe Community Christian Ministry also offers a free medication-assistance program for folks who qualify.
The program covers some of the more expensive brand-name drugs that are not on the $4 lists, explains Monica Barber, the nonprofit's pharmacy coordinator. To qualify, you must be a Buncombe County resident with no health insurance, Medicare or Medicaid assistance. There's also an income limit, which Barber says amounts to about $1,500 a month for a single person. In addition, you must be under a doctor's care — and, of course, have a prescription.
At present, some 175 people are enrolled in the program. To find out if you qualify, call ABCCM at 259-5339 and schedule an appointment.
The Buncombe County Medical Society Foundation runs Project Access, which enlists volunteer physicians and other health facilities to provide free care to qualified applicants. People enrolled in Project Access are also given (mostly) free drugs.
Last year, for example, roughly 3,500 patients received free care from Project Access providers; in the process, the project also covered the costs of some 6,800 prescriptions worth about $250,000, according to Jana Kellam, director of BCMSF health access programs. Some prescriptions require a $5 co-pay that covers up to $250 per prescription.
Care and medication are available to Buncombe County residents, usually ages 18 to 64, who have no medical insurance, don't qualify for Medicaid or Medicare, are low-income and have a medical need. Patients must first be referred by the Buncombe County Health Center, a community clinic or a private doctor. Potential beneficiaries are then screened by phone.
There's no set limit on how long Project Access participants may remain in the program, but enrollment typically lasts about 6 months.
For more information, visit www.bcmsonline.org/pa/pp or call 274-6989.
Council on Aging
Although it doesn't provide direct drug assistance, the local office of the nonprofit Council on Aging offers a Senior Health Insurance Information Program that helps low-income Medicare beneficiaries apply for subsidies to reduce medication costs. The subsidies are administered through the Social Security Administration's Extra Help program.
To receive free help applying for Extra Help, call the Council on Aging at 277-8288 and ask for either Nathan Johnson or Sybil French.
Appalachia School of Holistic Herbalism
Looking for herbal medicines on the cheap? West Asheville's Appalachia School of Herbalism offers short, low-cost classes such as "Stocking the Natural Medicine Cabinet," "How to Make Your Own Herbal Remedies" and "Weeds and Foods as Medicines."
"A large part of what we offer is the classes, so people can figure out how to take care of themselves with herbal medicines that are more financially accessible than pharmaceuticals," explains Ceara Foley, the school's director.
The school also features a free herbal clinic, wherein clients work with interns under faculty supervision and can purchase herbs at cost from the school's apothecary of more than 100 dried herbs and 600 alcohol extracts.
Community members can also take advantage of the school's library, which contains more than 500 books on holistic health and sustainable living. It's open Tuesday through Friday from noon to 6 p.m. and Saturdays from 9:30 a.m. to 12:30 p.m.
For more information, call 350-1221, or visit www.herbsheal.com.
The Asheville-based Eblen-Kimmel Charities provides several kinds of financial assistance to Western North Carolina residents who have medical needs they can't meet on their own. Among their offerings are a medication-assistance program for adults and a children's pharmacy, both of which collaborate with a network of local pharmacies to help those in need get their meds at the lowest possible cost.
The programs are first-come, first-served and have several criteria for eligibility.
For more information, call 255-3066.
Western North Carolina Community Health Services
Western North Carolina Community Health Services recently took over many services previously handled by the Buncombe County Health Center. The clinic has numerous ways of providing medicine at substantially reduced costs, usually through subsidies, depending on a patient's insurance status, income level and other factors.
"We evaluate on a case-by-case basis," explains Executive Director Carlos Gomez, noting that sometimes even the most basic fees are waived, depending on the level of need and the availability of drugs donated by pharmaceutical companies. When fees are waived, it's for a specified period of time, after which patients are expected to be covered under disability provisions or to find a way to pay.
The WNCCHS clinic is at 257 Biltmore Ave. in downtown Asheville; call 285-0622 to schedule an appointment and learn about eligibility criteria.
Jon Elliston can be reached at email@example.com or at 251-1333, ext. 127.