Background: Several studies have shown that cost plays an important role in patient noncompliance with their prescribed medications and that noncompliance with medications is associated with increased morbidity and mortality. Medication assistance programs, available through pharmaceutical companies, provide medications free of cost to patients who otherwise could not afford them, do not have insurance, and are not eligible for Medicaid or Medicare. Purpose: To determine if a comprehensive database of medication assistance programs, available to health care providers via the Internet (PharmFree), is an effective mechanism for increasing access to medications for indigent patients who otherwise could not afford their medications. If a health care provider wishes to access the database, he simply navigates to the PharmFree Web-site at any computer connected to the Internet. The provider puts in the name of the medication that he wishes to provide to the patient free of cost. The screen will return a listing of all pharmaceutical companies in the database that have assistance programs for the requested medication (with their respective application forms). The application is filled out and faxed to the pharmaceutical company. The patient usually receives the medication in 5-10 working days. Initially, PharmFree will be accessible to only one of the three firms in the primary care clinic (by use of a password). Providers at the other two clinic firms will not have access to PharmFree, however all the clinic firms will continue to have access to social services already in place. If an indigent patient in any clinic firm needs assistance to pay for medications, his name, address, and telephone number will be recorded. Two to 4 weeks after a patient requests medication assistance, he will be contacted to determine if the prescribed medications were received, how much medication was provided, and if he is compliant with his medications. Patients in the different clinic firms will be followed for one year in order to assess differences in patient access to and compliance with medications.
