Peer Responses:

• Relate to another journal reading
• Chronic conditions such as hypertension, type 2 diabetes, cholesterolemia, etc need an adequate pharmacological treatment to manage the condition when the patient cannot control the disease with their lifestyle adjustment. Otherwise, negative consequences may occur and lead to fatal effects. Existing barriers that analyzed by the Institute of Medicine (IOM) may prevent the individual to access to healthcare services and medications includes low healthcare literacy, income, negative attitudes towards treatment, lack of health coverage, and structural barriers such as inaccessibility to the healthcare facility (Ali, Cobran, & Young, 2022). Fortunately, the national organizations such as the Health Resources and Service Administration (HRSA), Federally Qualified Health Centers (FQHCs) (including Community Health Centers (CHCs), Migrant Health Centers (MHCs), Health Care for the Homeless (HCH), and Public Housing Primary Care (PHPC)), and HRSA Bureau of Primary Health Care (BPHC) have been implementing strategies to help patients and community to get health access, as well as prescriptions coverages (Ali, Cobran, & Young, 2022). According to the article by Ali and their coauthors, the FQHCs “mitigate cost-related access barriers by offering medications at a significantly reduced price primarily through two programs: 340B drug pricing program and prescription assistance program (PAP)” (2022). However, compared with low-income patients who get covered by Medicaid, patients being treated at FQHCs get less prescription medications (Ali, Cobran, & Young, 2022).
• According to the CommonWealth of Massachusetts, patients with low-income can get insured

by MassHealth program and primary care clinician can educate the patient regarding getting prescription medications via 340B program (Healey, Driscoll, Walsh, & Levine, 2023). Also, Prescription Advantage is another program in MA that allows residents aged 65+, as well as younger people with disabilities who are income eligible to get lower cost for prescription medications (Commonwealth of Massachusetts, 2024). In addition, as mentioned earlier, PAP or charitable drug programs is a strong program in MA that provides access to prescription medications for eligible individuals. The clinician should refer the patient to an appropriate social worker that can explain and verify the patient’s eligibility for the program based on their socioeconomic background and health status.  

Healthcare providers play a significant role in assessing the patient’s ability to pay for medications, potential expense of medication regimens, and patient insurance’s coverage so that they can help the patient to identify the best medication with lower cost (Kiessling, et al., 2022). The article by Kiessling and their co-authors emphasizes that clinicians can consider prescribing generic medication and using discount coupons can result in low-cost for patients (2022). In short, as a healthcare provider, we should always assess the ability to pay for treatment plans, and strategies to help lower the cost of medication as an approach to improve quality of care.