BY JEFFREY LEWIS AND DR. CHRISTINA GARCIA
Special to the Journal
With rising inflation, skyrocketing gasoline prices and families financially crippled by mounting food costs, some people must forgo or delay filling or refilling life-saving medications because they can no longer afford them, even where they have insurance. While no one in financial distress should have to choose between food, medicine or being able to drive to work, that is today’s reality.
Nothing is being done to insulate working families against rising insurance costs, which include ever-increasing prescription drug co-payments. While Washington could address these challenges, nothing has happened. As the suffering grows, the political rhetoric intensifies.
It is time to de-escalate the rhetoric with a real solution. So, Legacy Health Endowment and the EMC Health Foundation, in collaboration with TIN Rx, a local pharmacy in Turlock, have created PharmAffordable, a $2 charitable generic drug program covering more than 690 generic medications.
The program is limited to people living in 19 ZIP codes spanning southern Stanislaus and northern Merced counties. This is the region where Legacy Health Endowment and the EMC Health Foundation were created to use charitable dollars to address the myriad of healthcare challenges that daily confront residents.
PharmAffordable targets financially needy women and men with employer-provided insurance as well as the uninsured. People enrolled in Medi-Cal, Medicare and Tricare (Veterans benefits) are not eligible due to special rules imposed by those programs, unfortunately.
PharmAffordable is a pilot charitable program limited to only residents of the following communities: Atwater, Ballico, Ceres, Crows Landing, Delhi, Denair, Gustine, Santa Nella, Hilmar, Hughson, Keyes, Livingston, Bret Harte, Newman, Patterson, Stevinson, Turlock and Winton.
To be eligible, people must also certify that they are in financial distress such that they cannot afford either the regular price of the medications or their insurance copay or deductible for the same medications.
Once they have qualified to participate in the $2 generic drug program, residents must go to the TIN Rx pharmacy at 1801 Colorado Ave., Suite 300, Turlock, and present proof of residence in one of the 19 ZIP codes listed above. People must also certify that they are in financial distress such that they cannot afford either the regular price of the medications or their insurance copay or deductible for the same medications, and they will need either to confirm that they are uninsured or provide a copy of their health insurance card.
The savings could amount to hundreds of dollars a year in many cases. For instance, take a family in which the wife regularly takes medication for a thyroid issue and her husband has to take medication for high blood pressure. Their co-pays currently range from $10 to $65 per month. Under PharmAffordable, their co-pays would both be $2 a month – saving them about $700 annually.
With more than 690 commonly prescribed generic medications available under PharmAffordable, there are many opportunities for families in financial distress to save money that can be used for food, gas, rent, or clothing, or saved for a college education.
Families are struggling. They are being forced to make difficult choices, and some involve potentially life-threatening healthcare decisions. We are collaborating on a solution through innovation, negotiation, and stewardship. PharmAffordable is not a panacea, but it is an essential first step in disrupting the status quo and putting families first.
— Jeffrey Lewis is President and CEO of EMC Health Foundation and Legacy Health Endowment, and Dr. Christina Garcia is the founder and CEO of TIN
Rx. The views expressed are those of the authors.