Louisiana's Statewide Pharmacy Access Initiative’s purpose is to improve the health status of Louisiana residents through implementing an appropriate, integrated and effective state approach to increasing access to pharmacy services and pharmaceuticals by the underinsured and uninsured populations in the state.

New Initiative: CMAP Express Medication Access Program
CMAP Express is a medication assistance program for persons who live in the covered areas and meet the income guidelines, and have no other insurance that covers prescription drugs.

Eligible persons are those whose income falls at or below 200% of the federal poverty level, uninsured, and are 18 years of age and older.  Based on limitations, especially income restrictions, these populations normally would not adhere to their physician’s orders and medication regimen.  Direct medication assistance to these vulnerable populations reinforces consistent physician visits, increases direct patient care services, and encourages maintenance of chronic disease regimens, therefore minimizing the risk of disease progression and state health care costs.   

Click here for Federal Poverty Guidelines Income Worksheet to determine eligibility [PDF File].

CMAP is available to the following parishes: Allen, Avoyelles, Beauregard, Bienville, Bossier, Caldwell, Cameron, Catahoula, Desoto, Evangeline, East Carroll, Grant, Jackson, Jefferson Davis, LaSalle, Lincoln, Morehouse, Natchitoches, Rapides, Red River, Richland, Sabine, Union, Vernon, Winn, and West Carroll.

We are expanding the CMAP program to the following parishes: Acadia, Claiborne, Concordia, Franklin, Madison, St. Landry, Tensas, and Webster.  CMAP will have a selected implementation in Jefferson, Orleans, Plaquemines, St. Bernard, and St. Tammany parishes.

If you reside in one of the listed parishes, or know some one who may qualified for this program call 1-888-443-7494 or visit CMAP on line at http://www.cmaprx.org/

CMAP Extra
CMAP is committed not only to caring for those we serve, but to providing communities throughout Louisiana access to innovative programs which make healthcare more affordable and accessible.  That is why we are pleased to announce you are eligible to participate in CMAP Extra, designed to help lower your family’s medication costs.  Participation in the CMAP Extra program is provided to you at no monthly cost, and by using it you can save money on all prescription medications, including name brand and generic drugs.  This benefit is available to everyone regardless of age or income and you even qualify if you have current coverage.

The features of the CMAP Extra are:

• There is no cost to register for the program and there are no monthly membership fees for participants.
• Citizenship or residency is not required.  The card does not expire.
• No limit on the number of prescriptions per year.
• Program participants receive significant savings off retail in the purchase of prescription medications.
• This is not insurance; no claims to file, no formularies, no caps, no exclusions.
• Program is designed to assist those without insurance or prescription benefits, but it can also be useful to individuals who have exceeded their policy limits, have high deductibles or who need non-covered medications.

To enroll, visit CMAP’s Web site at www.cmaprx.org and click on CMAP Extra.

Other Pharmcy Access Work
In addition, the Bureau will work to expand the capacity of the region’s existing primary care practices, out patient clinics, public health units and school-based health centers.  The Bureau also will focus on integrating dental health and mental health services, prescription assistance programs and transportation services with primary care expansion efforts.

Contact Information
For more information, contact Jeffrey Greenwald by phone at (225) 342-1191 or by e-mail at jeff.greenwald@la.gov.

Background Information about Louisiana's Statewide Pharmacy Access Program

• Spending on prescription drugs in the United States increased at an average annual rate of 14.5% from 1997 to 2002, topping $162 billion in 2002 and continues to increase today.
• The rapid increases in prescription drug spending are placing a growing burden on consumers, employers and public programs. At the state level, spending increases for prescription drugs are placing financial pressure on Medicaid and on other health financing programs managed by states, including retiree health systems and state prescription drug subsidy programs.
• Prescription drug spending increases account for a growing proportion of Medicaid expenditures
• Spending on prescription drugs will almost surely continue to increase rapidly during the next decade. As more new pharmaceuticals come onto the market and the scope of new therapies becomes broader, demand will increase for new and better drugs.
• An important first step for states that are interested in controlling costs and ensuring effective and safe use of pharmaceuticals is to use data to assess their needs and develop interventions. National studies provide general trends in spending and use, but states need data specific to their individual prescription drug programs to make informed decisions.
• Costs of clinic and emergency treatment continue to increase dramatically despite that fact that many diseases and conditions could be easily managed and treated in a more cost-effective manner with prescription drugs if available.

There is genuine opportunity to improve access to pharmaceuticals and pharmacy services through statewide, regional, and local efforts while increasing the capacity of communities to better serve their under and uninsured populations. Through a comprehensive process of community engagement, needs and capacity assessment, and best practices research, the State Pharmacy Access Initiative (the Initiative) developed a working model of pharmacy access to provide pharmaceuticals and pharmacy services for the underserved population in the state. This process included:
• Formally recognizing problem and need (as expressed in HCR 231)
• Engaging stakeholders through forums and workgroups
• Collecting individual perspectives through interviews of Federal, State, and local stakeholders
• Reviewing other models in the country and associated strengths/weaknesses
Through this process, the Initiative learned that:
• Any state approach must begin with manageable steps.
• Community based solutions are key to meet the unique needs and capacities of individual communities.
• Shared information about pharmacy access activities and opportunities at the local, regional, and state levels can lead to a reduction in the duplication of efforts, increased collaborations between distinct provider types, increased resource sharing and leveraging, and increased efforts to take advantage of economies of scale.
• Many regions have existing or developing pharmacy access collaborations that could serve a much larger population of under/uninsured with some financial and technical assistance.

Program Streams
Community Based Pharmacy Access Networks
With the purpose of facilitating the formation of a statewide network of coordinated/centralized systems of pharmacy access that includes not only distribution of donated and/or purchased pharmaceuticals but also serve as a resource for the broader system of healthcare, the Initiative is supporting regional community based projects. The goal of each project is to demonstrate improved structural efficiencies and health outcomes through developing, expanding or strengthening regional coordinated and/or centralized systems of pharmacy access for underserved populations. As a part of the statewide network, projects will demonstrate improved pharmacy access for target population through indicators that may include among others:
– Increased number of access sites/enrolled providers
– Increased number of target population accessing pharmacy services
– Increased dollar amount of pharmaceuticals procured for target population
The Initiative is currently working with each of our initial projects to establish baseline measures. In addition, the Initiative is applying for Federal funding to allow ULM to conduct outcome evaluations and pharmacy access research related to the demonstration projects and the state initiative.

After a competitive application process, the Initiative recently announced the first 4 community based pharmacy access demonstration project awards. These projects, in addition to the local work they will be conducting, will work together through a statewide council of pharmacy access based on a model developed for healthcare recovery projects in the post hurricane environment. These projects include:
• The Lafayette Community Health Care Clinic will work to expand the capacity and geographic reach of the Community Pharmacy and to increase access to free medications for a larger group of under and uninsured residents.
• The North Louisiana Regional Alliance will develop a regional coordinated system of pharmacy services to be integrated with primary and preventive care in the region.
• The Louisiana Public Health Institute will establish a referral process for pharmacy assistance to create a seamless system of medication access across regional health care providers.
• The Bayou Teche Community Health Network (ByNet) in Franklin will support the expansion and integration of pharmacy access software into the area’s triage network. This network matches patient needs with community resources and assist patients in applying for pharmaceutical assistance programs.
The first formal meeting of the project leaders that will form the core of the Pharmacy Access Council will take place in conjunction with the Initiative’s Pharmacy Access Conference in March 2007.

Optimization of 340B Federal Drug Pricing Program
Efforts to assist eligible healthcare providers in enrolling and/or optimizing their utilization of the Federal 340B Drug Pricing Program have thus far been challenging but are realizing gains. Working closely with the HRSA Office of Pharmacy Affairs’ Pharmacy Support Services Center, the Initiative has engaged small groups of eligible entities and provided them with the information and resources necessary to realize cost savings in their purchase of pharmaceuticals and expansion of coverage through pharmacy networks. To date, three Federally Qualified Health Centers (FQHC’s) have taken advantage of this opportunity and are in the process of optimizing the 340B Program. Several others are now considering the benefits of the program. The initiative is also working with a group of FQHC’s in developing a 340B pharmacy network through the Office of Pharmacy Affairs’ Alternate Methods Demonstration Project program. In addition, a group of LSU HSC pharmacies have entered into a support contract to develop a 340B Pharmacy Network among their facilities. The Initiative is currently working with the Pharmacy Support Services Center to provide a cost-benefit analysis for eligible DSH hospitals that are not currently enrolled in the 340B Program. Finally, the Initiative has begun exploring ways in which it may assist eligible state entities/departments (the Office of Mental Health for instance) in taking full advantage of the 340B Program. With technical assistance from the Office of Pharmacy Affairs, the initiative will host a 340B Technical Conference for all eligible entities in March 2007.

Pharmacology of Chronic Disease Management
The Initiative hopes to take advantage of recent opportunities within the Bureau of Primary Care and Rural Health to examine the role “pharmacy” may play in chronic disease management and address barriers to access for those underserved populations managing chronic diseases. From a recent Chronic Disease Strategic Planning Conference, it became clear that the pharmacology of chronic disease management is a key element of preventing and managing chronic diseases. The Initiative is currently working closely with the Tobacco Control Program and the Tobacco Free Living Program to develop a clinical pharmacy pilot project addressing tobacco cessation. It is expected that similar efforts in Diabetes Management, Heart and Stroke Prevention and Support, and Asthma Management will develop as the relationship between the Initiative and the Chronic Disease Unit develops.