A pharmacy resource for uninsured patients

Pictured above: The staff of NOVA ScriptsCentral serves the patients of 26 safety-net clinics throughout northern Virginia.

Donney John

NOVA ScriptsCentral (NSC), a nonprofit pharmacy serving 26 safety-net clinics throughout northern Virginia, provides more than free or low-cost prescriptions for uninsured children and adults. According to Interim Executive Director Donney John, PharmD, the nonprofit pharmacy partners with each clinic to provide patient-centered care.

Since 2007, NSC has been able to provide $30 million worth of medications to the most vulnerable residents of Alexandria, Arlington, Fairfax/Falls Church, Loudoun, and Prince William, Va. The need for these prescriptions and care continues.

“There is a big demand for medication access. The only way the majority of [uninsured] patients get medications is through NOVA Scripts,” said John, a practicing pharmacist, healthcare consultant, and entrepreneur. “Without us, patients would have no access to life-saving medications such as prescription inhalers, insulin, or other chronic disease meds.”

New model

This program, in which multiple safety-net clinics share one pharmacy, is unique to Virginia and the metropolitan area at this time, but it could serve as a national model for prescription access for the uninsured.

“We want to share best practices and some of the struggles that we have had and overcome to help others who want to start a charitable nonprofit pharmacy [such as NSC],” John said.

For the past seven years, NSC has grown from a full-time staff of four employees assisted by volunteers to a staff of eight, including one full-time and one part-time pharmacist and two pharmacy technicians. NSC staff work directly with medical staff at the partner clinics, filling prescriptions for brand-name and generic medications indicated for most chronic diseases, including mental health conditions and HIV. NSC also offers patient counseling by telephone and supplies clinic staff with talking points to relay to patients about new drugs.

Partnerships

NSC’s community health centers and free clinic members have partnered with Northwestern, Harvard, Louisiana State, and Emory Universities in a study testing a simplified English-language prescription label for low-literacy populations. The bottom of the simplified Rx label displays the pharmacy name, creating enough space to make the important information prominent: the patient’s name, the disease to be treated, and directions on how and when to take the medication.

“The new labels take the guesswork out of pill-taking by placing the number of pills for morning, noon, evening, or bedtime in a graphic representation or universal medicine schedule,” John said.

NSC also is working with approximately 300 patients from two partner safety-net clinics who are taking part in a two-year medication adherence study, funded through Kaiser Permanente.

The ALL/PHASE study is a program focusing on reduction of cardiovascular disease that Kaiser initiated in 2003. The A-L-L regimen employs aspirin, lisinopril, and lipid-lowering therapy; P-H-A-S-E represents “Preventing Heart Attacks and Strokes Everyday,” through exercise, lifestyle changes for weight reduction, and smoking cessation.

Kaiser found that patients who adhered for one year to the ALL/PHASE program, including to standard-dose ACE inhibitors and statins, had a 60% reduction in myocardial infarction and stroke. Kaiser extended its program with funding to safety-net clinics in the mid-Atlantic region to help improve clinical outcomes.

“The study started early this year. We are using text messaging to patients’ cell phones and automated messaging to landlines to engage patients and
encourage them to take their medications. We also troubleshoot any barriers for why they may not be taking their medicines,” John said. “Although we have a small team [at NSC], we can make a profound impact on thousands of people on a yearly basis.”