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Mar 16, 2010
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Living


Filling Prescriptions

Service designed for low-income people without insurance

It's a good guess that anyone entering the eastside office of the Medicine Cabinet has medical problems. But Janie Anderson is actually wearing hers on her sleeve.

"You like them?" Anderson asks, displaying the bracelets she received at MountainView Hospital the night before.


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The 46-year-old mother of four proudly refuses to remove them.

"If I'm gonna pay for them, I'm gonna wear them!" she jokes.

The Medicine Cabinet is a patient advocacy service that helps bring medication to Las Vegans who can't afford it. Its clients number 1,200.

"People have lost hope," says director Janis Brooks. "If you're an insulin-dependent diabetic and you don't have insurance, you're spending $500 a month or more on medications to keep you alive, and that's not right.

"Or you just don't do it and you die instead."

Anderson checked into MountainView complaining of back pain and vomiting. Now she has an $800 hospital bill and prescriptions to fill to the tune of $300 per month. Like 700,000 Nevadans, according to a 2004 Families USA report, she has no health insurance. This seems ironic considering her profession: certified nursing assistant.

"I actually saw some people I worked with there last night," Anderson says of her hospital visit.

Because she temps -- earning $15 an hour from Global Staffing -- Anderson receives no benefits.

"I guess I'll pay the bill out of my pocket in installments," she says. "And the family will chip in. That's how you have to do it."

Brooks has better news for Anderson on the medication front. She qualifies to receive free shipments of Carafate, Ultram and Prilosec every three months. Nearly every pharmaceutical company gives drugs away free to those who can prove a need for them, a lack of health insurance, and financial hardship (usually, up to twice the federally set poverty level, which means up to $42,000 a year for a family of four).

"People just don't get it," Brooks says. "They think it's a scam or it's not real."

There is another problem, though, at least according to Brooks. She says that none of the patient assistance programs are particularly easy to find or enroll in.

"It's not in their best interest to advertise," Brooks says. "If they were bombarded by a million people at one time, I'm sure that would be something they would have to work out. But the way they have it now is so minimal, they don't have a problem."

Brooks -- a retired marble and tile setter from Pamona, Calif. -- opened the Medicine Cabinet in 2003, when her father was diagnosed with diabetes and couldn't afford all his medication.

"His doctor was the one who told us that there are some patient assistance programs that help people," she says. "But he didn't know how to get in contact with them. So I began research to find out if it was true."

The Medicine Cabinet now liaises with 390 manufacturers to provide one-stop access to 4,000 brand-name meds (including 23 used to treat HIV/AIDS). When patients don't qualify for the brand names, or when none is available, Brooks helps secure them generics through the Rx Outreach program. Patients never pay more than $14 per month each for these.

Brooks estimates she has saved her clients more than $2.5 million since launching her program. However, while she is helping people, she charges for it: $25 per month and $25 to enroll each year. That doesn't sit well with some.

"At different times, we have had low income people contact us because they could not afford the fees associated with the Medicine Cabinet," says Sherlene Simpson, quality assurance specialist with the Nevada Governor's Office Consumer Health Assistance program, whose rxhelp4nv.com Web site links visitors to Needymeds.com or PPARX.org (Partnership for Prescription Assistance), both of which are free services.

Brooks says those sites are fine for patients with one or two drugs to chase.

"But most of our patients are on seven or more drugs, and it becomes difficult," she says. "Basically, what they do is give you a phone number and tell you to contact each pharmaceutical manufacturer and go through the process yourself."

The documentation required by most manufacturers includes a valid ID, a month's worth of paycheck stubs, a tax return, prescription and physician's information. Brooks helps her clients obtain any of these they may not have.

"And they're not telling you that you need a doctor," Brooks says, adding that at least half of her clients hadn't been to a doctor's office "in years" before turning to the Medicine Cabinet to help treat chronic illnesses such as diabetes, high blood pressure and glaucoma.

In addition to preparing applications and maintaining active prescriptions, Brooks and two other employees (one part time) regularly work with the four Las Vegas clinics of Nevada Health Center, referring patients to doctors, picking up their drugs and dropping off their applications.

Brooks says GlaxoSmithKline, Merck, Pfizer, Lily, Beauringer and Wyeth require that advocates, not patients, complete their applications -- as a screening mechanism. (GlaxoSmithKline confirmed this policy, Pfizer and Wyeth denied it. Representatives for Merck, Lily and Beauringer did not return phone calls by press time.)

Glaxo spokeswoman Nancy Pekarek adds, however, that "we recommend someone at the doctor's office to help, because most often, a nurse or someone else would be willing to make the call for them.

"And they of course don't charge a fee for making that call."

Brooks says that without the administrative services provided by her company, however, most of her clients would never bother getting their medication.

"I know I'm helping save their lives," she says.

Before her application was processed by the pharmaceutical companies, Janie Anderson received some good news: a job offer to become a full-time certified nursing assistant at St. Rose DeLima Dominican Hospital.

Her health benefits begin in July.

Contact reporter Corey Levitan at clevitan@ reviewjournal.com or 702-383-0456.

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