Clinical and Economic Impact of Pharmacy Services in a Low-Income Family Practice Clinic within a Community Hospital Setting

Abstract

Providing medical care to the underprivileged is a mission of the Sisters of St. Joseph at St. Joseph Hospital in Orange, California. An outpatient family medical clinic was established to serve this population, a majority of whom do not have health insurance or access to government-sponsored prescription assistance programs. To provide medications to patients and to help reduce medication costs, the pharmacy department opened a medication room in the clinic and staffed it with a pharmacist and a pharmacy technician. This effort involved maximizing the use of pharmaceutical companies’ patient assistance programs, which provide free medications to qualified indigent patients. The project also incorporated pharmacist-regulated involvement; the development of and compliance with a formulary; strict inventory controls on the purchase of medications; and identification of patients who qualify for government health service programs. A computer database program that simplified the tracking, reporting, and organizing of patient information and provided financial reports was implemented. Within three years of operation, medication costs decreased from $328,000 to $32,800. The presence of a pharmacist in this setting was advantageous in both the financial and clinical arenas. The pharmacist was intimately involved in medication provision by evaluating appropriate medication use in a cost-effective manner and providing education to health care providers and patients.