Implementation of a $4 generic drug program in a 340B pharmacy.

Purpose: The implementation of a $4 generic drug program in a 340B pharmacy is described.

Summary: The Cordelia Martin Health Center (CMHC) pharmacy operates as part of the Neighborhood Health Association, a federally qualified health center in Toledo, Ohio. Clinic patients have prescription coverage through Medicaid or do not have prescription coverage, and 89% of prescriptions without any form of prescription coverage are for patients whose income is at or below 200% of the federal poverty line. Financial transaction data at CMHC were analyzed to determine the financial viability of a program for $4 generic medications. Once this was determined to be a financially viable option, the $4 lists of mass-merchant pharmacies were obtained, and the drugs from the CMHC formulary that appeared on any of these lists were included on the $4 list of the CMHC pharmacy. A total of 93 medications were included on CMHC's list. The new pricing structure became effective in January 2009. The total number of prescriptions filled at the CMHC pharmacy from January to March 2009 was 7134. For the same three-month period in 2008, 6166 prescriptions were filled. In January-March 2009, the average prescription volume increased by 9 prescriptions per day in January, by 19 prescriptions per day in February, and by 23 prescriptions per day in March, compared with those months in 2008.

Conclusion: A $4 generic drug program implemented at a 340B pharmacy increased patients' access to medication and increased the pharmacy's prescription volume while contributing to an increase in the pharmacy's net revenue.