When Laurel Nuschke moved to St. Thomas with her husband Dr. Randell Nuschke three years ago, they found that a nationwide trend was hitting the territory particularly hard.
“He would see patients that did not have the wherewithal to fill their prescriptions,” she said.
Throughout the U.S., as the economy struggles and health care costs rise, more and more people are facing the dilemma: Buy medicine or pay the utility bill.
In the Virgin Islands, the situation is exacerbated because so many people are self-employed individuals laboring in a largely cash economy and/or seasonal employees working without benefits. They don’t have health insurance through their jobs, and they can’t get individual insurance.
“It leaves a lot of people out in the cold,” Nuschke said.
Nearly a third of the population, in fact.
Two weeks ago, the V.I. Healthcare Reform Implementation Task Force released what were described as “preliminary” figures from a recent survey showing that 29.7 percent of V.I. residents were uninsured in 2012. The average in the U.S. is 15.7 percent.
Some time before that report, Nuschke gathered some data herself, putting out a needs-assessment survey to doctors practicing in St. Thomas and St. John. Their responses told the story: Too many patients simply can’t afford the medicines they need.
To address the problem, Nuschke drew on her experience.
“My background is in pharmaceuticals and in non-profits, so I kind of merged the two,” and founded an organization called Patient Assist VI, Inc. The group helps patients connect with drug companies that have programs to supply free or drastically reduced medicines to people with limited resources.
It was set up last fall and began operating in January, with Nuschke as the executive director.
“This program is primarily geared toward the working poor,” Nuschke said. “A lot of hospitals in the states have this kind of program,” generally providing medicines that treat chronic conditions such as diabetes, asthma, hypertension and hyperlipidemia.
To be eligible for assistance, a patient must be uninsured for drug coverage, must have a Social Security number or a green card, and must meet specific income requirements. The income requirements are not overly stringent, but each drug company that offers assistance sets its own income level.
In the first three months of running the program, Nuschke said she has helped between 20 and 25 patients. Already, $50,000 worth of medications have been shipped into the territory under the auspices of Patient Assist VI. Most medicines are shipped directly to the patient; some, such as insulin, are sent to the patient’s doctor.
Most companies approve assistance for a patient for one year, so Patient Assist VI will also help track the contributions and apply for renewals, she said.
Nuschke said so far many of her clients have been referred to her by local doctors. She meets with the patients to determine eligibility, consults with their physicians and sends the applications to the pharmaceutical company whose program seems best suited to the client’s needs. The program also provides information regarding pricing at local drug stores, and about local discount programs.
Response from the community has been positive and wide-ranging.
Dr. James Clayton offered free office space, Nuschke said. His Red Hook Family Practice center is on St. Thomas’ East End, making it relatively convenient for patients from St. John as well as St. Thomas. Business people and professionals have helped Nuschke get the organization started, and attorney Erika Kellerhals donated her time to prepare the necessary paperwork. Volunteers constitute what little staff there is besides Nuschke.
While the group awaits the federal 501 (c) (3) ruling granting it standing as a non-profit, it is operating under the umbrella of the Community Foundation of the Virgin Islands which is acting as its fiscal sponsor. It also networks with Cancer Support VI and other local non-profits, sharing ideas and referrals.
Board members are Dr. Siri Akal, Rob Sckalor, Peter B. Corr, Rebecca Martorello, and Nuschke.
“It has potential to grow,” Nuschke said. She would like to expand the program to St. Croix once the St. Thomas-St. John service is well grounded.
She plans to provide reimbursement to eligible patients for medications that they can’t get through the drug companies but must pay for out-of-pocket. That aspect of the service will require some major fundraising efforts in the community.
Nuschke can be reached by sending anemail to [email protected] or calling 1-340-775-0055 or 1-609-408-5265.