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In North Carolina, NC MedAssist supports patients in over 100 counties with charitable medicine. The organization, with more than $182 million in medical aid from Direct Relief since 2014, is filling the gap for patients who would otherwise go without.
Direct Relief staff delivered medical support to NC MedAssist, a charitable pharmacy in Charlotte, North Carolina, on Oct. 7, 2024, as part of Hurricane Helene response efforts. NC MedAssist ships medications across the state, primarily to patients who are uninsured. (Photo by David Uttley for Direct Relief)
In North Carolina, some patients face an amputation before learning that the insulin they needed could have arrived in the mail for free, said Brenda Vass, chief executive of NC MedAssist.
The Charlotte-based nonprofit supplies free prescription drugs to uninsured North Carolinians. It also offers free over-the-counter medicine to all.
Yet eliminating the price of medication has not been enough to ensure access for everyone who needs it. Several barriers remain, Vass explained, due to funding shortfalls that make publicizing and fully staffing the program a challenge.
State support has helped NC MedAssist expand, but funding has not consistently met the organization’s requests. With limited resources, Vass said, operational work takes precedence over publicizing it.
“We’re not going to pay money around marketing,” he said.
Direct Relief staff delivered medical support to NC MedAssist, a charitable pharmacy in Charlotte, North Carolina, on Oct. 7, 2024, as part of Hurricane Helene response efforts. In addition to everyday responses to those in need, NC MedAssist operates as an emergency responder during natural disasters. (Photo by David Uttley for Direct Relief)
The tradeoff leaves the nonprofit trying to reach people directly who may also have little contact with the organizations that could refer them, such as safety net health centers, hospitals, or social workers.
NC MedAssist’s free prescription program serves uninsured residents with incomes up to 300% of the federal poverty level, a threshold Vass said it raised after the pandemic because so many families could not afford their medications. Across rural North Carolina, limited access to well-paying jobs and struggling health care facilities compound the problem.
The organization reports serving more than 11,100 patients through its prescription program. In fiscal 2026, it dispensed medications valued at $41.8 million, using average wholesale prices, according to its program statistics. NC MedAssist is Direct Relief’s second-largest U.S. partner for medicine donations. It also participates in Direct Relief’s ReplenishRx program.
The Direct Relief program helps clinics and charitable pharmacies maintain a steady supply of donated medications while reducing the need for separate applications to drugmakers’ patient assistance programs.
The nonprofit also takes free over-the-counter medications into communities through its Mobile Free Pharmacy program, which held 53 events and served 37,246 people in fiscal 2026, according to the organization. Its over-the-counter program is open to all residents.
A distribution event of over-the-counter products for NC MedAssist patients is seen in North Carolina. (Courtesy photo)
Medicines distributed include pain relievers, cough and cold treatments, children’s medicines and vitamins. Donating partners include Second Harvest Food Bank, Genexa, Direct Relief and Cencora.
Other safety-net organizations are invited to participate, allowing residents to seek help with additional needs during the same visit.
In addition to shoring up the healthcare system on a daily basis, NC MedAssist is active as an emergency responder, helping to ensure patients don’t lose access to needed medications during hurricanes and other extreme weather events.
Reaching Patients Across 100 Counties
NC MedAssist has about 30 employees serving North Carolina’s 100 counties. Four focus on outreach, two in western North Carolina, one in Charlotte, and one in the eastern part of the state.
“It’s not nearly enough, but it’s what we have,” Vass said.
Limary Cruz, Social Worker for NC MedAssist, helps an applicant in Charlotte, NC (Photo courtesy of NC MedAssist)
Those workers build relationships with free clinics and federally qualified health centers, whose patients may qualify for medication assistance without realizing it. A referral can connect someone already receiving medical care with a way to fill a prescription.
But the connection often depends on an individual clinic employee. When that person leaves, the referral process can break down.
“They take their knowledge with them,” Vass said.
She wants referrals to become a routine part of how partner clinics operate, rather than something dependent on a particular worker. Otherwise, patients may leave with enough medication for a week, or in the case of a hospital stay, with no medicine at all, and no clear way to obtain any medication in the future.
From 21 Days to Three
Asked where additional funding could make the greatest difference, Vass pointed to a staff position: someone to help patients apply, answer questions, and navigate the process.
An approved application, however, is not the end of the work. About 60% of the people NC MedAssist serves speak English as a second language, Vass said. Some have struggled to understand how to renew prescriptions or take their medications. The organization has worked to make its instructions more accessible and to provide bilingual assistance.
“It really does take a person talking to you over the phone to explain to you how to take it,” she said.
The organization is a critical connector between patients and medications they need but might not be able to pay for. (Courtesy photo)
Making time for those conversations has required changes inside the nonprofit. After eliminating 12 positions over two years, NC MedAssist examined the tasks overwhelming its remaining employees. Much of the burden was administrative, including preparing reports, processing paperwork, and retyping applications into its system.
Employees wanted time to ask whether patients understood their medications or needed help obtaining food. Instead, they were occupied with the paperwork required to serve them.
Recent technology changes have shortened application processing from 21 days to three, Vass said. Social workers now spend about 30% of their time on paperwork, down from 60%, allowing more time for calls and referrals in just a few months.
Even with those improvements and thousands of patients served, Vass remains focused on the people the organization has yet to reach.
“As long as people are going without, we haven’t served enough,” Vass said.
Direct Relief has supported NC MedAssist with more than $182 million in medical aid since 2014.
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