Since 2016, the American College of Cardiology (ACC) has initiated several projects to distribute more than $250,000 to chapters across the country. One initiative in North Carolina aimed to provide uninsured cardiac patients with medication free of charge. Details of the project were outlined in an article published in the Journal of the American College of Cardiology.
Free or charitable clinics are largely supported by donations and grants, such as the one provided by the ACC North Carolina chapter. Patients who are homeless, in poverty, or uninsured for other reasons often rely on these clinics for medical care. Because heart disease is a major concern for North Carolinians, with 1 in 5 cardiovascular-related deaths in North Carolina occurring in persons under the age of 65, the ACC funding initiative focused on providing lipid-lowering therapy and clopidogrel to clinics for use by the uninsured population. Over 2 years, the project provided free medication to a total of 9 clinics throughout North Carolina. After the study period, the clinics provided data on the types of medications dispensed and the total cholesterol and low-density lipoprotein (LDL) levels of a random sample of patients.
In the first year, 1296 patients received a total of 178,384 tablets. In the project’s second year, 1550 patients were provided with 279,474 tablets. There was an increase in dispensing and number of patients receiving statins after the initiation of the funding, with a 349% increase in use for year 1 and an additional 38% in year 2. Overall, there was a significant decrease in both total cholesterol and total LDL levels in patients at the clinics providing free medication. Analysis of a random sample of patients showed that after year 1, cholesterol levels decreased from 205 mg/dL to 179 mg/dL and LDL levels decreased from 123 mg/dL to 103 mg/dL. These levels showed a decrease in a random sampling of year 2 patients as well.
The project between the North Carolina ACC and the clinics shows that providing vulnerable, uninsured patients with free medication is a feasible way to improve cardiovascular health indicators in that population. Based on the results of this particular project, the ACC hopes to bring the initiative to other parts of the country and other medical specialties.
Stouffer GA, Abernethy WB, Zidar JP, Wilson BH. Improving patient access to medication. J Am Coll Cardiol. 2019:74:3066-3068. doi: 10.1016/j.jacc.2019.11.002. http://www.onlinejacc.org/content/74/24/3066.