Expanding Contraceptive Options Through an Institutional Patient Assistance Program

The program has absolutely made a difference for our clinic and patients. Patients wanted long-term contraception and were surprised that there was an option available to them free of charge.” – Michelle Hubbard, Dream Centers Women’s Clinic

Without insurance coverage, the cost of birth control can be unaffordable. At Medicines360, our mission is to remove cost as a barrier to health by developing and providing affordable women’s health products. We make our anchor product available at a price that is a discount to the 340B ceiling price to clinics participating in the 340B Drug Pricing Program. However, not all safety-net clinics can access 340B pricing.

In 2018, to expand access to hormonal IUDs among safety-net clinics that cannot access 340B pricing, Medicines360 partnered with Direct Relief, a humanitarian aid organization, to establish the IUD Access Partnership, an institutional patient assistance program (IPAP). IPAPs provide prescription drugs free of charge to participating safety-net clinics via bulk shipments. Clinics that are eligible to participate in the IUD Access Partnership must serve low-income clients and may not purchase product through the 340B program.  

We recently spoke to providers at two of the 32 clinics participating in the IUD Access Partnership. Both are free clinics [i] and serve primarily uninsured patients, many of whom are undocumented immigrants.

  • Dream Centers Women’s Clinic in Colorado Springsis one of the only free clinics that focuses on women’s health in the state. We spoke with Michelle Hubbard, Clinic Operations Director.
  • Volunteers in Medicine of Southern Nevada (VMSN) in Las Vegas provides free primary and several specialty health care services to approximately 60 patients per day. We spoke with Desiree Zapinsky, Medical Practice Manager, and Yonnabelyn Arteaga, Family Planning Medical Assistant.

Both clinics are only able to offer contraception through patient assistance programs, and as such, are limited in the range of birth control methods that they can provide onsite. Dream Centers is only able to provide oral contraceptive pills and our anchor product, while VMSN provides those two methods plus the injectable contraceptive. Hubbard and Arteaga described counseling patients on the full range of contraceptive methods, but then having to refer patients to other clinics, such as the local health departments, for most of those methods.

Hubbard said, “It’s hard to tell the patients that they need to go to another clinic. Many of our patients feel that they are served badly elsewhere, especially if there are language barriers. They feel safe and cared for with us and may not follow through on referrals to other clinics.”

Hubbard explained that when she and her colleagues learned about the IUD Access Partnership,We didn’t have to think about saying yes, it was just, ‘How do we do it?’ This IPAP allows us to give our patients another option.”

Traditional patient assistance programs require patients to apply individually then wait to receive their prescribed drugs. In contrast, IPAPs such as the IUD Access Partnership enroll entire clinics, allowing clinics to keep product in stock and available for immediate dispensing to eligible patients. This process reduces paperwork for the clinic and the need for a return visit, which is often prohibitively expensive and inconvenient for low-income patients. Direct Relief replenishes the participating clinics’ stocks as needed.

VSMN used a traditional patient assistance program before switching to the IPAP from Medicines360 and Direct Relief. Arteaga explained the advantage of an IPAP such as the IUD Access Partnership over traditional patient assistance programs: “With the previous program, we helped our patients fill out the application, but the approval process could take a month or more. Now we have hormonal IUDs in stock and, if our gynecologist is in the clinic, we can insert the IUD the same day. It is a lot more convenient for us and the patient.”

In its first year participating in the IUD Access Partnership, Dream Centers received 48 hormonal IUDs. Since VMSN joined the IPAP in June 2019, it has received 34 units. The IUD Access Partnership has distributed 716 units since the program started.

Both Dream Centers and VMSN had strong relationships with Direct Relief before enrolling in the IUD Access Partnership. Medicines360 is pleased to work with Direct Relief and grateful to the participating clinics for the care that they provide to patients.


[i] Free and Charitable Clinics are a sub-set of the U.S. healthcare “safety-net.” These organizations utilize a volunteer/staff model to provide a range of medical, dental, pharmacy, vision and/or behavioral health services and restrict eligibility for these services to individuals who are uninsured, underinsured and/or have limited or no access to primary, specialty or prescription healthcare.

About Medicines360

Medicines360, located in San Francisco, California, is a nonprofit global women’s health pharmaceutical organization with a mission to catalyze equitable access to medicines and devices through product development, policy advocacy, and collaboration with global and US partners. Medicines360, through its subsidiary Impact RH360, launched the Avibela Project to expand access to hormonal IUDs in low- and middle-income countries. For more information, visit medicines360.org

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AVIBELA can be made available in the following 88 countries

  1. Algeria
  2. Angola
  3. Bangladesh
  4. Belize
  5. Benin
  6. Bhutan
  7. Botswana
  8. Burkina Faso
  9. Burundi
  10. Cambodia
  11. Cameroon
  12. Cape Verde
  13. Central African Republic
  14. Chad
  15. Comoros
  16. Costa Rica
  17. Cuba
  18. Democratic Republic of the Congo
  19. Djibouti
  20. Dominica
  21. Dominican Republic
  22. Egypt
  23. El Salvador
  24. Equatorial Guinea
  25. Eritrea
  26. Ethiopia
  27. Gabon
  28. Ghana
  29. Grenada
  30. Guatemala
  31. Guinea
  32. Guinea-Bissau
  33. Haiti
  34. Honduras
  35. India
  36. Indonesia
  37. Ivory Coast
  38. Jamaica
  39. Kenya
  40. Lao PDR
  41. Lesotho
  42. Liberia
  43. Libya
  44. Madagascar
  45. Malawi
  46. Malaysia
  47. Maldives
  48. Mali
  49. Mauritania
  50. Mauritius
  51. Mayotte
  52. Morocco
  53. Mozambique
  54. Myanmar
  55. Namibia
  56. Nepal
  57. Nicaragua
  58. Niger
  59. Nigeria
  60. Pakistan
  61. Panama
  62. Papua New Guinea
  63. Philippines
  64. Republic of the Congo
  65. Rwanda
  66. Sao Tome and Principe
  67. Senegal
  68. Seychelles
  69. Sierra Leone
  70. Somalia
  71. South Africa
  72. South Sudan
  73. Sri Lanka
  74. Kitts and Nevis
  75. Lucia
  76. Vincent & the Grenadines
  77. Sudan
  78. Swaziland
  79. Tanzania
  80. Thailand
  81. The Gambia
  82. Timor-Leste
  83. Togo
  84. Tunisia
  85. Uganda
  86. Vietnam
  87. Zambia
  88. Sri Lanka

Tina Raine-Bennett, MD, MPH, FACOG

Chief Executive Officer

Tina Raine-Bennett, MD, MPH, is CEO of Medicines360. Previously, she served as a senior research scientist at the Kaiser Permanente Northern California Division of Research and the research director of the Women’s Health Research Institute. She is a Board-Certified Obstetrician Gynecologist who received her medical training at the University of California, San Diego, and post-graduate residency training and MPH at the University of Washington in Seattle, where she also completed a Robert Wood Johnson Clinical Scholars Fellowship. She was also senior staff physician at Kaiser Permanente and has a special interest in family planning and adolescent reproductive health.

As the director of the Women’s Health Research Institute, Dr. Raine-Bennett focused on expanding research on women’s health within the Division and translating women’s health research into clinical practice and policy within the Ob/Gyn departments in Northern California. She also promoted the involvement of clinicians in research designed to improve the health outcomes and healthcare experiences of women at Kaiser Permanente and women in general.

Prior to Kaiser Permanente, Dr. Raine-Bennett was a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at University of California, San Francisco (UCSF). She was based at San Francisco General Hospital where she was also the medical director of the New Generation Health Center, a UCSF affiliate site that provides community-based reproductive health services. Dr. Raine-Bennett’s research has focused on contraceptive methods and on elucidating factors that influence contraceptive choice and continuation, and she was principal investigator on NIH grants to assess hormonal contraceptive use predictors and develop interventions to improve contraceptive access.

Her past and current research on emergency contraception has focused on the safety of making emergency contraception more accessible and she conducted a pivotal clinical trial to make emergency contraception available to teens without a prescription. She served on the editorial board of Obstetrics and Gynecology and has over 100 peer-reviewed publications. She was the Treasurer of the Board of Directors for the Society of Family Planning and Society of Family Planning Research Fund. She has also served as an examiner for the American Board of Obstetrics and Gynecology, and on national committees for the American College of Obstetrics and Gynecology and the National Medical Board of Planned Parenthood Federation of America.