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Executive Summary

Development of a standardized "prescription blank" to be used by physicians prescribing drugs for indigent patients is one recommendation included in a Senate Aging Committee "status report" released Aug. 10 on the "accessibility and affordability of prescription drugs for older Americans." The report suggests that a standardized prescribing form for indigent patients would both reduce patient waiting time for prescriptions, thereby improving compliance, and reduce the burden on physicians to contact companies and process paperwork. In addition, the report suggests that such an approach also would provide the indigent patient "with the benefit of talking to the pharmacist about medications." Currently, nearly all company-sponsored indigent patient programs require that a patient's physician act as a go-between: physicians are generally responsible for enrolling a patient in a company program as well as for receiving and distributing drugs from such programs. As an alternative to a special "prescription blank," the report suggests that physicians could use a stamp "with some phrase or coding indicating that the patient is eligible for one of these programs." The recommendation for a standardized prescription blank for indigent patient programs is one of three recommendations offered in the report to improve awareness and utilization of such programs. The report also includes a directory of 35 pharmaceutical companies that offer such programs developed from a survey conducted by Senate Aging Committee staff during the spring (see related story, p. 8). "It is laudable that pharmaceutical manufacturers have, for several years, voluntarily offered programs to assist some of the poorest Americans obtain life-saving medications," the report states. "However, the limited scope of these programs, the small number of recipients, the cumbersome distribution system, and the minimal awareness among indigent patients indicate that these drug company programs may not be fulfilling their mission." The report notes that company programs "are usually promoted to the physician through word-of-mouth by the local sales representative of the pharmaceutical manufacturer and are rarely promoted to the indigent patients who need them the most." Consequently, the report adds, "only a very small number of indigent patients are benefiting from the programs at this time." The report also recommends that the drug industry establish "a panel of representatives from the medical and pharmacy communities and elderly advocacy groups to identify ways to reform current indigent patient programs" and to look into ways to better disseminate information about these programs. This group, the report suggests, could be responsible for publishing an annual directory of such company programs. The Aging Committee staff's third recommendation is that the pharmaceutical industry go beyond physician groups in its effort to spread the word on indigent patient programs. The Pharmaceutical Manufacturers Association recently put out its own directory of indigent patient programs that is being sent out to physician groups. PMA also established a toll-free hotline. The report suggests that the hot-line number be disseminated to pharmacy and nursing professionals as well as organizations "involved in providing social services to indigent older Americans, such as Area Agencies on Aging, and advocacy groups representing older Americans." The report, which includes the indigent patient program directory as an appendix, is primarily about the difficulty that many elderly patients have in paying for prescription drugs and reflects Sen. Pryor's (D-Ark.) continued interest in expanding outpatient drug coverage. The report resurrects many of the arguments from the Medicare Catastrophic Coverage Act debate supported by updated data. The preface to the report, signed by Pryor and ranking minority member on the Aging Committee Sen. Cohen (R-Maine), states that "during the current and upcoming debate on health care reform, it will be imperative for the Congress to address the very important issues of access to and costs of prescription medications."

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