Brenda Helsell said she doesn't know if she would be alive if not for the St. Vincent de Paul Charitable Pharmacy.
Helsell, 56, has suffered from asthma for years wouldn't be able to get the prescription inhalers used to treat the disease and ease attacks if the pharmacy didn't offer them free of charge.
"I couldn't afford them," said Helsell, a $13.60-an-hour certified nursing assistant who does not get health insurance at the privately owned assisted living center where she works "full-time plus."
She went without the medications for a while, Helsell recalled.
"I was always in the emergency room," she said. "Panicked. Scared because I couldn't breathe."
Helsell is one of hundreds of low-income, uninsured patients who receive their medical prescriptions free from the pharmacy, located in the lower level of St. Vincent de Paul-Madison headquarters at 2033 Fish Hatchery Road.
The program is run in partnership with the University of Wisconsin-Madison. Faculty from the School of Pharmacy helped found the program and clinical professor Yolanda Tolson-Eveans is its managing pharmacist.
The charitable pharmacy was one of seven collaborations honored Wednesday with the 2017 Community-University Partnership Awards.
The partnerships help the university fulfill its mission, said Leslie Orrantia, UW-Madison director of community relations.
"UW-Madison, as a land grant institution, was established to improve the lives of residents across our great state. Fulfillment of this everlasting vision may not be possible without ensuring communities across Wisconsin continuously inform the aims of our institution,” she said in a news release. Partnerships like the charitable pharmacy help "collaboratively facilitate positive change."
Other partnership programs recognized include:
- Literacy Network of Madison’s Path to Citizenship program offering classes to help lawful permanent residents pass the citizenship test
- Urban Community Arts Network, examining racialized barriers faced by Madison hip-hop artists
- Wisconsin Plain Community Project, improving access to sensitive, affordable health care for Amish and Mennonite families in the LaFarge area
- Community-Academic Aging Research Network, supporting research to improve older adults’ health
- Adam County-UW Madison Partnership to Reduce Rural Cancer Disparities, educating rural communities
- Healthy Hmong Women, training Southeast Asian immigrants in Milwaukee as health education on cervical and breast cancer
The St. Vincent de Paul Charitable Pharmacy gets medications to people who need them and can’t afford them, and also helps teach UW-Madison students who volunteer or serve internships at the facility.
“Our goal here is to teach student how to provide care with care,” said Tolson-Eveans.
Students take clients’ blood pressure at each visit and talk with them about how they are doing, she said. “We consider things beyond medication. We look at social determinants, we look at housing and other things that are impacting their ability to be well.”
Serving a low-income, uninsured populations requires pharmacy staff to be nimble, Tolson-Eveans said. The pharmacist on duty often needs to call prescribing doctors to get authority to change an order from a brand-name drug to one that is therapeutically equivalent.
Ralph Middlecamp is the executive director and CEO of St. Vincent de Paul- Madison, a Catholic nonprofit organization. The Charitable Pharmacy is the only stand-alone pharmacy dispensing free medications in the state, Middlecamp said.
He said that for many of the pharmacy’s clients, a visit becomes an important monthly contact with a health professional who can help coordinate medications that may have been prescribed by more than one physician seen in different settings, like clinics or emergency rooms.
The pharmacy filled 4,878 prescriptions for 749 patients this fiscal year, through May 31, dispensing $447,591 in medications, St. Vincent staff said.
In 2014, the pharmacy served 1,025 patients, a number that dropped by 50 percent the following year when many low-income, formerly uninsured people began to get insurance under the federal Affordable Care Act.
The number of people seeking service has been increasing in the improving economy of the past two years, Middlecamp said. For example, some people found work and lost Medicaid benefits, but did do not get health insurance benefits through their employers.
To be eligible for the program, patients must have a valid prescription, be uninsured adults and have a household income at or less than twice the federal poverty level.
The pharmacy focuses on medications for chronic conditions and does not carry any controlled prescription drugs, such as opioids.
If any replacement program for ACA adopted by Congress does not include prescription drug coverage or adequate coverage of maintenance medication, the impact on demand for pharmacy will be dramatic, Middlecamp said.
St. Vincent’s had for years issued vouchers for prescription medication at its facility where it also runs food pantry, clothing and housing programs. By the time the organization was buying $80,000 worth of prescriptions a year, it became clear it could run its own pharmacy at little cost change. “That was the tipping point,” Middlecamp said. The pharmacy opened in April 2013.
Today the pharmacy costs about $190,000 a year to run, including salaries and drug purchases. Half of that budget is paid for through sales at the seven Dane County thrift stores St. Vincent’s operates, he said. Grants and donations are sought to cover other costs.
Medications for asthma, high blood pressure, high cholesterol and diabetes are in highest demand at the pharmacy, mirroring national disease trends, Tolson-Eveans said.
The medications are obtained from a variety of sources. The pharmacy contracts with Nashville-based Dispensary of Hope, a non-profit distributor of drugs donated by pharmaceutical companies, to get many of the drugs it carries for $7,500 a year, she said.
The pharmacy also works directly with a couple of pharmaceutical companies to get donated stock, including respiratory inhalers and vaccines, which can be administered there, Tolson-Eveans said.
The pharmacy also is a state-approved repository that can accept donated unused, unopened and unexpired medications from the public, she said.
The program is currently purchasing insulin for treatment of diabetes, a drug in increasing demand for which she has not been able to find a good donated source, said Tolson-Eveans.
The demand for medications for low-income, uninsured patients is growing, said Chris Palombo, CEO of Dispensary of Hope.
“We have 140 sites and we’re growing every month,” Palombo said. He said drug manufacturers have offered his organization some two billion doses of surplus medications over the past four years.
The companies also offer drugs “straight off the assembly line” to fill needs for which there are not adequate surpluses, Palombo said.
They get practice in dispensing drugs, but the students working at the pharmacy said it was the patient contact that was most gratifying. Volunteer Amanda Bernarde said that she’s realizing what an important role pharmacists can play in helping patients improve their health.
“And this patient population is unique," she said. "They’re very grateful for what we do here.”
Intern Brock Dantuma also works as a pharmacy technician at a Madison hospital and said working at St. Vincent’s has helped him learn to be more compassionate.
“If people are really sick, they make their medications a priority. But if you’re feeling fine and can’t really afford it, taking your blood pressure medication can fall to the wayside,” he said.
Helsell picked up a half-dozen medications from the pharmacy, including prescriptions for asthma and some over-the-counter medications for what she said was near-constant joint pain from the physical demands of her job.
She has told a few friends about the program, she said.
“People just can’t afford insurance,” she said. “And when you get it, it doesn’t cover anything.”