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Senior PharmAssist copes with growth

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Gina Upchurch

Gina Upchurch

Todd Cohen

DURHAM, N.C. — Senior PharmAssist in Durham expects over the next year to serve more than 1,600 individuals in Durham who need assistance with prescription medicine.

That’s up from 1,400 in the fiscal year ended June 30 and will include at least 700 older adults who need counseling on their often-complicated Medicare coverage, up from 600 in the just-ended fiscal year.

In the face of rising demand for services, compounded by the ailing economy and cuts in government funds, Senior PharmAssist has posted budget deficits for three straight years, reversing the pattern of many years.

“Our budget has grown dramatically, and our expenses have exceeded our growth,” says Gina Upchurch, the nonprofit’s founding executive director.

To better address demand, she says, Senior PharmAssist aims to be more aggressive and strategic in recruiting larger gifts from corporations and individuals.

Building on support from GlaxoSmithKline for 13 years, she says, the agency is working to diversity its corporate support by reaching out to other companies, particularly in Research Triangle Park.

Senior PharmAssist grew out of a summer internship for Upchurch with the Durham County Hospital Corporation in 1992, when she was a graduate student at the School of Public Health at the University of North Carolina at Chapel Hill.

In her work, she found that older adults could not afford prescription medicine, and that some were getting medicines they might not need or that were causing them harm.

“So they needed better medication-therapy management,” now known as “medication reconciliation,” an approach designed to keep all providers on “the same page with regard to medication,” she says.

With a three-year start-up grant of $305,000 from the Duke Endowment, Senior PharmAssist opened on June 23, 1994.

For the fiscal year that began July 1, the agency is operating with an annual budget of nearly $756,000, up from $549,000 five years ago, and a staff of eight people.

In addition to medication management, the group provides clients with payment for medicine or access to free medicine through patient-assistance programs offered by drug-makers.

As part of that program, pharmacists review all the medications a Senior PharmAssist client is taking, and the agency in turn communicates about that list with the client’s health-care providers and caregivers.

Senior PharmAssist also provides program participants with Medicare insurance counseling related to prescriptions and medical care, helping them, for example, sort through the drug-care benefits provided through Medicare Part D, and select the benefit that will save the client the most money and ensuring access to the medicines they need, Upchurch says.

At the end of 2009 and 2010, she says, two thirds of the agency’s participants needed to switch Medicare Part D drug-care plans, with the average savings totaling nearly $600 a year, and the median savings totaling roughly $300, meaning half the clients saved more and half saved less.

Senior PharmAssist also refers clients to programs or vendors that provide products or services they need, such as medical supplies, food or payment of their Medicare premium.

It also encourages clients to “understand that they have to be their own best advocate” to better navigate the complex and constantly-changing world of health-care benefits.

With businesses accounting for only 12 percent of its revenue, and earned income only 4 percent, Senior PharmAssist is working to increase both.

A 17th-anniversary event in June at Mez Restaurant in Durham attracted 65 guests, including representatives of 10 businesses.

And the agency has set a goal of raising $100,000 this fiscal year from companies in Research Triangle Park, and another $100,000 from other health-care institutions.

So far, Upchurch says, GSK is expected to give $40,000 through a fund at the Triangle Community Foundation, while Merck is giving $20,000 and Talecris, recently acquired by Grifols, is giving $15,000.

Senior PharmAssist also is advocating to increase collaboration with local hospitals as part of the effort to improve the health-care system.

“We want money from the health-care system because, starting in October 2012, hospitals are going to be rewarded or punished depending on re-admission rates,” she says.

And research by Senior PharmAssist shows the rates of any hospital admissions and emergency-department visits by people who have been in its program for two years decline, respectively, by 51 percent and 27 percent.

“Not only does our program treat people with respect and all the other things you would expect,” Upchurch says, “but it has an effect on their use of the health-care system and it needs to be part of health-care reform in our community and other communities.”

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