Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Ste 1900, New Orleans, LA 70112. Email:
Am J Manag Care. 2018 Mar;24(5 Suppl):S67-S73.
Federally qualified health centers (FQHCs) are essential to underinsured populations in the safety net by offering them several means of access to reduced cost medications. This study employed a 2-pronged approach to evaluate FQHCs' role, estimating both the need for patient assistance and the impact of the safety net.
A multiyear panel data study for post-Affordable Care Act (ACA) years 2012 to 2016 and a 2016 cross-sectional analysis design were utilized to analyze FQHCs, their patient populations, and prescription assistance programs.
Publicly available Health Resources and Services Administration (HRSA) Uniform Data System data were merged with HRSA Office of Pharmacy Affairs Information System data on 340B programs. Descriptive statistics were produced to evaluate the need for patient assistance, costs, and conditions treated at FQHCs.
There were 1337 FQHCs serving more than 2.5 million patients, nearly 29% of whom were uninsured. FQHCs utilized 2 programs to provide affordable, reduced-cost prescriptions for patients without insurance: 1) the HRSA 340B Drug Pricing Program and 2) prescription assistance programs, which rely on pharmaceutical manufacturer donations of reduced-cost medications or coupons. Although these programs were effective at providing affordable prescriptions, program accessibility varied widely by state and FQHC resources.
Despite changes in the healthcare access landscape due to the ACA, underinsured populations remain prevalent and the need for financial assistance with medications persists. FQHCs are uniquely situated to provide access to these essential services. Further policy and funding efforts, such as expansion of 340B programs, could assist FQHCs in fulfilling the role of prescription safety-net providers.
联邦合格的健康中心（FQHCs）通过为参保不足的人群提供多种获得低成本药物的途径，成为保障网中的重要一环。本研究采用双管齐下的方法评估 FQHCs 的作用，既估算了患者援助的需求，也评估了保障网的影响。
这项研究利用了一项多年期的面板数据研究，针对《平价医疗法案》（ACA）之后的 2012 年至 2016 年期间，并结合了 2016 年的横断面分析设计，用于分析 FQHCs、其患者群体和处方援助计划。
公共卫生资源和服务管理局（HRSA）统一数据系统的数据与 HRSA 药房事务信息系统的 340B 计划数据进行了合并。通过描述性统计数据评估了 FQHCs 的患者援助需求、成本和治疗条件。
有 1337 家 FQHCs 为超过 250 万患者提供服务，其中近 29%的患者没有保险。FQHCs 使用了 2 个项目为没有保险的患者提供负担得起的、降低成本的处方：1）HRSA 的 340B 药品定价计划；2）处方援助计划，该计划依赖于制药商捐赠的低成本药物或优惠券。尽管这些项目在提供负担得起的处方方面非常有效，但项目的可及性因州和 FQHC 资源的不同而有很大差异。
尽管《平价医疗法案》改变了医疗保健获取的格局，但参保不足的人群仍然很普遍，对药物的经济援助需求仍然存在。FQHCs 处于提供这些基本服务的独特地位。进一步的政策和资金投入，如扩大 340B 计划，可能有助于 FQHCs 发挥处方保障网提供者的作用。
