Strengthening the U. S. medication safety net by connecting abundance to need

Charles C. Chima, Marino A. Bruce, Desiree B. Pendergrass, Roland J. Thorpe, Lori M. Ward, Hillary F. Blackburn, Christopher F. Palombo, Bettina M. Beech

Research output: Contribution to journalArticlepeer-review


Cost-related medication non-adherence (CRN) is a major population health concern in the United States, especially for patients with chronic conditions. It is associated with disease progression and increases the likelihood of emergency department utilization and hospitalization, thereby increasing overall health care expenditures. In this paper, we describe the prescription medication safety net in the United States and assess its reliability. We also introduce Dispensary of Hope (DoH), a charitable medication distribution network, as a reliable medication access program that is capable of filling gaps in medication coverage for low-income and uninsured Americans. Our critical assessment of the medication safety net in the United States suggests that an expansion of DoH could reduce CRN in the United States, improve chronic illness care, and help health systems achieve the triple aim of improving patient experiences and population health while reducing cost.

Original languageEnglish (US)
Pages (from-to)503-518
Number of pages16
JournalJournal of health care for the poor and underserved
Issue number2
StatePublished - May 2020


  • Charitable medication distribution
  • Low income
  • Medication access
  • Medication safety net
  • Patient assistance program
  • Population health
  • Underinsured
  • Uninsured
  • Vulnerable populations

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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