Medication assistance programs: do all in need benefit equally?

OBJECTIVE To determine if medication assistance programs (MAPs) provided by pharmaceutical companies were used differently by African Americans and Whites. RESEARCH DESIGN A cross-sectional survey was conducted among patients of primary care practices from 2005 to 2007 within the Alabama Nonsteroidal Anti-Inflammatory Drug (NSAID) Patient Safety Study. SETTING Telephone survey. PARTICIPANTS Respondents were 568 African American and White patients reporting annual household incomes < $50,000. MAIN OUTCOME MEASURE Use of MAPs. RESULTS Of all patients, 12.8% used MAPs, 39.5% were African American, 75.2% were female, 69.1% were aged > 65 years, 79.8% had annual household incomes < $25,000, and 35.5% indicated that their income was inadequate to meet their basic needs. MAPs were used by 11.2% African-Americans and 14.0% Whites. After multivariable adjustment, MAP use was higher among respondents with incomes not adequate to meet basic needs (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.17-4.08) but lower among African Americans than Whites (OR: 0.49, 95% CI: 0.25-0.95). Physician characteristics did not independently predict MAP use. CONCLUSIONS Overall MAP use was low even among the most vulnerable, and especially among African Americans. As currently used, MAPs may contribute to disparities in medication access.