Charitable pharmacies improve access to prescription medications
The growing role of charitable pharmacies in meeting unmet needs in the uninsured and underinsured populations
Recently, The RxRoundtable hosted two pharmacist-entrepreneurs that are operating charitable pharmacies in very distinct parts of the country. NOVA ScriptsCentral’s Executive Director is Donney John, PharmD and he runs a “charitable pharmacy central fill” operation that services 16 clinics in the Northern Virginia area. Rusty Curington, PharmD, Vice President of Pharmacy, St. Vincent de Paul Charitable Pharmacy joined us as well for this dialogue, and he oversees the operations and delivery of services and medications at three sites in the greater Cincinnati, Ohio region.
I have had the opportunity to visit with NOVA ScriptsCentral on several occasions and meet with their pharmacy team. The role of the charitable pharmacy is growing, and the entrepreneurial model that each pharmacy leader brings to their unique operations and the blend of clinical services they offer is what makes “meeting the patient where they are” and true patient engagement come alive inside of their four walls and in the greater broader communities in which they operate.
Together, the combined insights of these two individuals as to the critical role charitable pharmacies play in addressing access and affordability challenges for vulnerable populations across the United States was illuminating to this prominent group of consultants convening through The RxRoundtable.
By definition, a community charitable pharmacy is a pharmacy which serves with the expressed purpose of improving health outcomes among the vulnerable by reducing health disparities and increasing medication access. Common to both NOVA ScriptsCentral and St. Vincent de Paul Charitable Pharmacy are that these are mission-driven, nonprofit organizations, that exist primarily to improve health outcomes by reducing health disparities and increasing medication access for uninsured and underinsured patients.
From central fill to clinic-integrated, access grows via donation programs
Charitable pharmacies dispense a broad formulary of medications at no cost or significantly reduced cost, focusing on eligible individuals based on financial criteria, typically aligned with federal poverty levels. Their operations must comply with all local and federal regulations, and models vary from standalone pharmacies serving uninsured patients exclusively to mixed models integrated into clinics or hospital campuses, sometimes serving both insured and uninsured individuals.
When you have seen one charitable pharmacy, you have seen one charitable pharmacy. No two charitable pharmacies are exactly alike, as some operate solely under the charity model, while others adopt a mixed approach, dispensing medication for both charity and for-profit purposes or functioning within clinics and hospitals.
Additionally, many states have enacted legislation supporting drug repository programs, enabling the donation and redistribution of unused prescription medications. As of 2023, 48 states and Guam have some form of law permitting drug donation and reuse, with prominent examples like SafeNetRx in Iowa, Wyoming’s Medication Donation Program, Georgia’s Good Pill Pharmacy, Oklahoma’s program, and Ohio’s law that took effect in May 2023 which permits the donation of unexpired medications to charitable pharmacies, hospitals, or nonprofit clinics from the public. This includes medications that may be leftover due a change in regimen or the death of a loved one.
Philanthropy-fueled care with comprehensive services and volunteer-powered teams
Funding for charitable pharmacies is multifaceted, utilizing dispensing fees or flat fees per prescription, grants from foundations, individual donations, and partnerships with health systems and insurance companies. While charitable pharmacies charge nominal fees for medications, most revenue derives from philanthropic and institutional grants, which support their limited operational budgets.
The scope of charitable pharmacy services is broad, including medication access, medication therapy management, immunizations, health education, care coordination, diabetes management, substance abuse disorder services and participation in health disparities research. These services are delivered by a diverse workforce, including volunteers, clinicians, and pharmacy professionals, many of whom help develop workforce capacity within healthcare by serving as training sites for students and new practitioners.
When you look at the passion and commitment of Rusty Curington, as an example, his career in the charitable pharmacy sector began when he was a student, doing a rotation while in pharmacy school at a charitable pharmacy. He knew then that his calling was to serve the underserved in the greater Cincinnati area, and he never looked back.
National collaboration, measurable impact, and a donated medicines supply chain
The network of charitable pharmacy directors is a tight one. They collaborate, connect and share successes and challenges on a regular basis. Additionally, there is an association that supports the role that they play as well—and that is the National Association of Free & Charitable Clinics (NAFC). This organization provides resources and data insights that point to the impact of charitable pharmacies and free clinics nationwide. Interestingly, in 2023, over 1.7 million unduplicated patients received care through 1,400 clinics and charitable pharmacies in the U.S., accounting for 5.7 million patient visits. The majority of these patients were uninsured or earning below 200% of the Federal Poverty Level, with most belonging to racial/ethnic minorities and a significant proportion gainfully employed. Medication access and chronic disease management, especially for diabetes and cardiovascular conditions, are highlighted as core missions, with programs offering zero-cost insulin and supporting health education and care coordination for chronic illnesses.
While most charitable pharmacies will have a very specific formulary and treat mostly chronic conditions, using generic medications, there are a small number of pharmaceutical companies that provide brand name products, including insulin, through donations to one of the three primary “wholesalers” that service charitable pharmacies. The three primary sources of product for these charitable pharmacies comes from Americares, Dispensary of Hope and Direct Relief. Additionally, the drug wholesalers can also serve as a channel for donated product from pharmaceutical companies to a charitable pharmacy.
Expanding community partnerships to reduce medication insecurity
As pharmacy deserts continue to grow in pockets throughout the United States (Stu Beatty’s updated data) and as many individuals find themselves no longer eligible for Medicaid, the expansion of charitable pharmacies will continue and the need to continue to develop collaborative opportunities between charitable pharmacies and other community services will also expand.
Charitable pharmacies provide a unique practice site for pharmacy teams. The varied clinical service offerings, the strong patient engagement, and the opportunities to drive better patient outcomes within an underserved population drives professional satisfaction within these settings.
Ultimately, it positions charitable pharmacies as pivotal community resources fighting medication insecurity by leveraging partnerships, reusing donated medicines, and maintaining a strong commitment to improving public health outcomes amid persistent affordability barriers.
If you have not had the opportunity to visit a charitable pharmacy, I would encourage you to plan your next visit. The passion of their personnel is palpable, and the creativity is unparalleled. The impact of their services is needed now more than ever, and the growth of this sector will continue to remain strong.
Links to charitable pharmacies and resources:
