Serving Underserved Transplant Recipients: Experience of a Medication Access Program.

Abstract

PURPOSE: Programs have been established to help solid-organ transplant recipients address medication regimen cost burden. However, beyond a very few studies, there is a dearth of information available in the literature regarding these programs. The purpose of this study was to describe the Medication Access Program (MAP) and the population of solid-organ transplant recipients it serves. An additional objective was to compare characteristics of recipients whose MAP enrollment was continued versus those who were discontinued during the annual re-enrollment period. METHODS: To enroll in MAP, a recipient completes an application which includes information about healthcare coverage, income, and medication regimen. Recipients re-enroll on an annual basis. MAP provides education regarding medication therapy and availability of medication assistance programs, and assists in the process of enrolling into medication assistance programs. Data were collected from the renewal applications for 2012 and 2011 (for those who did not return the 2012 renewal applications). Chi-square analyses and independent sample t-tests were conducted to assess differences in demographics, private healthcare coverage status, income, medical expenses, Medicare eligibility, and benefits eligibility between continued versus discontinued MAP recipients. We also examined recipient records for 2008-2011 to determine the number of times recipients had been previously discontinued (note, recipients are eligible to re-enroll in MAP after they are discontinued, provided all required documentation is completed). RESULTS: 246 recipients were included. The majority qualified for Medicare (67.9%) and Medicaid (69.9%), and did not have private healthcare coverage (63.8%). Significantly more continued recipients qualified for Medicare compared to discontinued recipients (p=0.002). Discontinued recipients had a significantly greater number of past discontinuations compared to continued recipients (p=0.01). CONCLUSIONS: MAP integrates education, medication assistance, and medication therapy management to promote medication adherence and positive health outcomes among solid-organ transplant recipients. Healthcare providers should use historical monitoring to identify high risk patients and implement programs that will facilitate continuity of care.