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Direct Relief’s ReplenishRx Increases Access to Donated Medicine for People Unable to Afford It


United States

A pharmacist at Cape Fear Clinic, Wilmington, North Carolina, in 2019. The clinic has on-site medical, pharmacy, and mental health services and is part of Direct Relief’s ReplenishRX program. (Photo by Donnie Lloyd Hedden for Direct Relief)

Direct Relief is increasing access to donated medicine to people who need it to keep chronic disease at bay but don’t have the means to pay for it. The program, called ReplenishRx, could eventually help tens of thousands of additional patients get the medicine they need to control diseases like diabetes and hypertension.

ReplenishRx is an enhanced version of a program that provided 91,000 prescriptions to more than 23,000 patients in 2022. ReplenishRx makes it easier for free clinics, community health centers, and charitable pharmacies to enroll in the program themselves, and in turn, makes it easier for providers to enroll individual patients.

ReplenishRx is a streamlined option for pharmaceutical and medical technology manufacturers to donate their products directly to safety net organizations that care for people without health insurance or other means to pay for them.

ReplenishRx provides free medicine only for people lacking any health insurance and with household income at or below 300% of the Federal poverty line. Neither patients nor private insurance companies, nor the government are billed for the medicine. People eligible for ReplenishRx assistance do not qualify for health coverage from their state’s Medicaid program and cannot afford to purchase health insurance.

Pharmaceutical companies or foundations donating medicine to ReplenishRx include AbbVie, Eli Lilly and Company, Johnson & Johnson Patient Assistance Foundation, Medicines360, and Sanofi Cares North America.

“Lilly is deeply committed to expanding access to our medicines,” said Patrik Jonsson, Executive Vice President; President, Lilly Immunology and Lilly USA; and Chief Customer Officer. “We appreciate that Direct Relief’s ReplenishRx program not only reduces administrative burdens on safety-net clinics but also streamlines the process so that patients with limited resources can get the medicines they need, when they need them.”

Lilly and Sanofi both donate insulin through ReplenishRx.

Direct Relief set up its original Replenishment program in 2008 to streamline availability of medicine to uninsured patients at safety net clinics that primarily serve uninsured patients, including Federally Qualified Health Centers and free and charitable clinics and pharmacies. The program was designed to make it easier for patients to get medicine, while improving delivery and management of inventory for safety net clinics and pharmaceutical manufacturers. It helps clinics and charitable pharmacies provide a steady supply of vital medicine to patients lacking insurance, without the need to apply to individual Patient Assistance Programs (PAPs) offered by pharmaceutical companies.

Pharmaceutical manufacturers ship donated medicine to Direct Relief’s warehouse in Santa Barbara, California. Direct Relief manages clinic enrollment, distribution logistics, and compliance oversight of the health clinics. The clinics enroll patients based on strict eligibility guidelines, track all inventory received from Direct Relief, dispense prescribed products to eligible patients, and report product usage back to Direct Relief. Direct Relief’s ReplenishRx enables manufacturers to reach a growing network of safety-net organizations.

“The program provides a consistent, steady supply of medication for patients who have no insurance, who are low-income and have diabetes or another chronic disease,” said Marisa Barnes, who runs the ReplenishRx program at Direct Relief. “We’re reducing the amount of paperwork that’s required to participate, which means more clinics and more patients will be able to take part in the program. We’re anticipating rapid growth, particularly in the provision of insulin.”

Traditional PAPs are most often used by individual patients, who seek out programs for specific drugs, apply themselves for admission and then apply for annual renewals. Many safety-net providers help patients submit and manage the paperwork or do it on their behalf. Each patient, including those enrolled by clinics, requires a separate application from each drug maker. Clinics often rely on volunteers to help patients manage the paperwork.

Direct Relief acts as a single point of contact between each clinic and all the pharmaceutical makers it works with. Each clinic requests all its donated medicine once a month for its eligible patients from Direct Relief, and each pharmaceutical company deals only with Direct Relief to distribute its donated medicine to enrolled clinics. Rather than having to continuously request refills for each drug, enrolled healthcare organizations each month report how much of a medicine they have used, and Direct Relief sends them the same amount of the drug again in a single monthly shipment.

ReplenishRx enables patients to receive medicine at the clinic during the same visit when it is prescribed, reducing the risk that the patient won’t follow through to obtain and take the medicine, and thus improving overall health outcomes.

“Direct Relief’s Replenishment Program streamlines the process of participating in manufacturers’ patient assistance programs for our low-income, uninsured patients,” said Jennifer Buxton, Acting Executive Director and Chief Operating Officer of Cape Fear Clinic Inc. in Wilmington, N.C. “But, perhaps more importantly, it removes the treatment delay by allowing our clinic to keep inventory on hand that is immediately available for use.”

“Direct Relief’s Replenishment Program has been a complete game-changer for NC MedAssist’s Free Pharmacy Program,” said Dustin Allen, Chief Operating Officer & Director of Pharmacy Operations at NC MedAssist in Charlotte, N.C., the only statewide nonprofit pharmacy in North Carolina. “By ordering medications via a single interface as opposed to four separate ones, it not only cuts down on time needed for order placement but also ensures consistent delivery of medications.”

The original Replenishment program required participating pharmacies to use pharmacy software that many of the smallest healthcare organizations lack. Under ReplenishRx, enrolled organizations can upload the necessary information from their electronic health record systems, allowing a wider degree of participation.

Direct Relief has also made it faster and easier for small healthcare organizations to enroll in the program. Under the original program, it could take eight months to a year for an organization to develop and document the standard operating procedures needed to ensure compliance with donation program requirements, which differ among pharma companies. Direct Relief has now developed a Standard Operating Procedures manual that healthcare organizations can integrate into their processes.

ReplenishRx is just one of the many ways Direct Relief provides support to health centers, free and charitable clinics and charitable pharmacies. Direct Relief’s core Safety Net Program donates medicine and medical supplies to more than 1,300 health clinic and charitable pharmacy locations. The program allows them to request donations of specific drugs, which Direct Relief allocates according to available supply and the number of patients each organization serves. In 2022, the Safety Net Program donated medicine with a wholesale value of $258 million. All the medicine Direct Relief donates to these organizations can be dispensed only to low-income patients lacking any health insurance.

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