Mar. 12--Sick, low-income Oregonians are scrambling for prescription medicines offered free through a maze of programs sponsored by pharmaceutical companies.

The programs are a godsend to many who have lost medical or prescription-drug coverage because of state budget cuts.

At the same time, however, the programs are complicated and difficult to understand. Each company has its own application forms, eligibility criteria and amounts and kinds of drugs they provide. And program requirements and application forms are constantly changing.

Patients who want to participate in the programs need the cooperation of their doctors in filling out forms and agreeing to distribute the pharmaceuticals, once the drug companies send them.

Because it can take 60 to 90 days from the time of application until the drugs arrive, patients have to seek free drug samples from doctors or rely on hospital funds for charity cases.

And while hospital officials say they appreciate the pharmacy companies' efforts, they say the lack of uniformity imposes a huge administrative burden, which severely limits the number of patients they can help.

One Web site, NeedyMeds.com, lists 179 pharmacy company programs along with 862 drugs that they make available.

Patients must be mentally agile to jump through the many hoops involved in the programs.

Schering Laboratories' patient assistance program requires proof of monthly income for all persons in the household, including current monthly pay stubs, Social Security documents and tax records.

Another company, Aventis, asks only that the patient's doctor certify that to the best of his or her knowledge, the patient has no prescription insurance coverage and can't afford to buy drugs.

Tracey Pickens, of Northeast Portland, feels like she's lost in a mishmash of confusing rules.

Pickens' life is a whirl of helping others. A single mother with three children, Pickens houses her grandmother, who has ovarian cancer, and her uncle, who was recently diagnosed with leukemia. One of Pickens' three sons has fragile X syndrome, an inherited disorder that causes symptoms including learning disabilities, anxiety and behavior that resembles autism.

In mid-January, her uncle, Donald Jackson, 51, received a letter notifying him that his benefits through the Medically Needy Program would be terminated by the end of the month.

Jackson was desperate. He takes at least seven drugs for depression, anxiety, sleeplessness, high blood pressure, abnormal blood clotting and infections.

"I didn't know what to think, what to do," Jackson said from his hospital bed at Providence Portland Medical Center, where he is being treated for leukemia. "If it hadn't been for Tracey, I'd be dead."

Pickens, a secretary, cruised the Internet looking for help for her uncle. She's used to doing that to check on treatments for her son.

Finally, she came across Web sites that led her to pharmaceutical companies that offer free help to low income people.

Pickens has carefully organized the paperwork required by a variety of pharmaceutical companies and she is being assisted by Providence Portland workers whose job it is to help patients navigate the shoals of free drug programs.

Rick Sahli, regional pharmacy director for Providence Health System in Portland, said the health system's medical assistance program, which helps low-income patients who can't afford drugs, has been flooded with calls.

Since the state's pharmacy cuts went into effect, Sahli said, "the number of people who need service has jumped."

In 2002, he said, the program helped 1,000 Providence patients get more than $1 million worth of free drugs.

There's more need now than last year, he said, but the hospital system can't afford to hire more people to process the applications.

In the Providence system in Portland about 31/2 positions are devoted to helping people get free drugs, he said. "It's a matter of resources. There are only so many resources an organization has."

Sahli said the Providence Health System medical assistance plan gets 15 to 20 calls a day. But because of the programs' complexity, he said, "We're lucky if we can initiate five to 10 patients a day."

The program operates on a first-come, first-served basis and the backlog is growing.

For most programs, he said, every patient must apply for each drug separately. "This is a very labor-intensive program," he said.

Rick Ralston, who runs Legacy Health System's outpatient medical assistance program, said the state's budget cuts have boosted demand there, too.

Legacy's outpatient program provides 200 patients with about 400 drugs, he said. There's far more demand but not enough resources to meet it.

Legacy officials are trying to come up with a way to prioritize the patients they help with drugs, Ralston said. The health system is planning to start pilot groups to teach people to fill out their own applications.

Gae Ryan, director of pharmacy services at Oregon Health & Science University, has also noticed more patients are applying for the programs. Patients can get information through a variety of Internet sites, but "these programs change all the time, so you need to have a site that updates pretty frequently."

Despite his illness, Donald Jackson is more fortunate than some. He has his niece on his side.

"I know how to do this," Pickens said. "But what about people who don't?"

This Article has been submitted by the Jeremy's Prophecy Dot Com team for informational and educational purposes. Jeremy's Prophecy Dot Com is a website dedicated to telling the story of Jeremy Jacobs, a character in the novel, Jeremy's Prophecy Dot Com.