The Cost of Medications at a Student-Run Free Clinic in New Haven, Connecticut, 2021–2023

TL;DR

A student-run free clinic in New Haven found that many low-income patients require expensive medications, with common prescriptions including asthma and cholesterol drugs.

Contribution

This study quantifies the cost burden of medications for uninsured patients at a free clinic and identifies frequently prescribed expensive drugs.

Findings

22% of patients were prescribed at least one medication costing over $20 per prescription.

Fluticasone propionate/salmeterol, medroxyprogesterone acetate, albuterol sulfate, and rosuvastatin were the most frequently prescribed expensive medications.

Patients prescribed expensive medications had median household income of $14,400, well below the federal poverty level.

Abstract

Haven is a student-run free clinic in New Haven, Connecticut, that serves more than 500 patients annually. Haven’s pharmacy department helps patients obtain medications by providing discount coupons or medications from the clinic’s in-house pharmacy, directly paying for medications at local pharmacies, and delivering medications to patients’ homes. This study aimed to identify prescriptions that have the highest cost among Haven patients.

Our sample consisted of all Haven patients who attended the clinic from March 2021 through March 2023. Patients were eligible to be seen at Haven if they were aged 18 to 65 years, lacked health insurance, and lived in New Haven. We determined the lowest cost of each medication prescribed to Haven patients by comparing prices among local pharmacies after applying a GoodRx discount. We defined expensive medication as more than $20 per prescription. We excluded medical supplies.

Of the 594 Haven patients in our sample, 64% (n = 378) required financial assistance and 22% (n = 129) were prescribed at least 1 expensive medication. Among 129 patients prescribed an expensive medication, the mean (SD) age was 45.0 (12.3) years; 65% were women, and 87% were Hispanic or Latino. Median (IQR) household annual income was $14,400 [$0–$24,000]. We identified 246 expensive medications; the median (IQR) price per prescription was $31.43 ($24.00–$52.02). The most frequently prescribed expensive medications were fluticasone propionate/salmeterol (accounting for 6% of all expensive medications), medroxyprogesterone acetate (6%), albuterol sulfate (5%), and rosuvastatin (5%).

The average Haven patient has an income well below the federal poverty level, and many have chronic cardiovascular and respiratory conditions that require expensive medications. Future research should work toward making medications universally affordable.

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