Valerie Jones MD

Medical Education Happenings
Research Demonstrates Value of
Prescription Assistance Program
By Lorraine Nelson
Washington State University Spokane
Retired Spokane physician Dr. Samuel Selinger was extremely
pleased when an academic journal published a research paper
April 1 about the Spokane Prescription Assistance Network (SPAN).
He was pleased not only because he and others had envisioned
and planned for the research study more than 10 years ago, but also
because of the paper’s findings – that a group of Spokane patients
experienced fewer hospitalizations and ER visits in the year after
they began receiving their medications consistently.
“This program has been such a phenomenal collaboration
involving state legislators of both parties, the pharmaceutical
industry, hospitals, universities, healthcare providers and clinics,”
Selinger said. “The research findings confirm that we’ve graduated
from a do-good program into something that is bringing healthcare
resources into the community and that is having a positive impact
on the health of the community.”
The research study was published in the peer-reviewed Journal
of Managed Care Pharmacy and showed there was an overall
decrease in emergency room visits and hospital admissions for
the 310 Spokane patients who participated in the study. Those
who received help with pulmonary medications had the largest
drop in those acute care contacts. However, not all the patients
experienced a decrease in acute care incidents. Those who were
taking psychotropic medications had more acute care contacts, and
so did the young adult age group 18-24. Those are questions not
answered by this study, but perhaps something for future research
projects, Selinger noted.
The lead author on the SPAN study is a Ph.D. student in
interdisciplinary studies at Washington State University Spokane.
Selinger served as a collaborating author on the paper, as did
Washington State University Spokane faculty in nursing, pharmacy
and medicine.
Selinger and the others who organized SPAN decided from its
opening in 2008 that SPAN would collect information from patients
for an eventual research study to measure the program’s value.
SPAN was the pilot project in what is now the statewide Prescription
Drug Assistance Foundation. The foundation actually grew out
of a larger project Selinger initiated to combine and distribute as
needed the charity care offered by Spokane’s physicians.
That was Project Access – an idea Selinger picked up from a
one-week healthcare course at the Kennedy School of Government
in the year 2000 shortly after he semi-retired from practice.
Selinger enlisted the help of the Spokane County Medical
Society, which put out the call for physicians to pool their charity
care, and almost immediately about 100 docs signed on. (That
has since grown to about 600.) Providence Health took on the
role of coordinating.
Once Project Access was up and running, organizers realized they
would have to address the issue of access to prescription medication.
“I was naïve as a doctor,” Selinger said. “I was a surgeon and
gave prescriptions after surgery and assumed the patient got the
Dr. Samuel Selinger
medicine. It wasn’t until I got into this nonprofit organization that
I realized there is a gap between prescribing medications and
compliance by the patient, either because they cannot afford
the medication or there is no one to get it for them or help them
remember to take it.”
The group of volunteers driving Project Access analyzed the
options, which were to buy and warehouse medications to give
to patients, or to work directly with the pharmaceutical companies
because they all have programs offering free and reduced-price
medicines to eligible low-income.
They opted to work with the companies, but rather than simply
refer the patients to the companies, they agreed upon a need to
have a patient prescription coordinator.
They went to state legislators in 2005 it was then-state Senate
Majority Leader Lisa Brown of Spokane who helped the group
get legislation passed to create the nonprofit Prescription Drug
Assistance Foundation.
After the pilot project was done in Spokane, the foundation
branched out across the state, but it remains based in Spokane.
Executive Director, Kelly Armstrong, is a social worker who staffs
patient clinics as well as oversees the statewide network of clinics
and coordinators, answers to a statewide board of directors, and
does fundraising and grant writing for the foundation.
Selinger has kept figures on the Spokane clinic and reports
it gets referrals of patients from about 62 different entities and
works directly with about 38 pharmaceutical companies to get
the medications. Providence has been the major funder of the
Spokane program, and provides it with office space and salary for
the director.
Selinger was chair of the foundation for a number of years until
he could no longer serve because of the term limits for the position.
He has since continued his involvement as a volunteer.
“Now that we have this paper which answers some questions
about the impact of this program and shows we are successful,”
Selinger said, “I am hoping to give the reins to this project over to
the next generation and say ‘Here’s this wonderful project that you
can grow, and because it is such a unique collaboration among so
many different segments of the community, we can be models and
leaders for others.’” n
The Message | May 2016 | 7