DECATUR - Current economic woes and rising gas prices mean sacrifices and choices for many.

But with escalating costs forcing some to decide between paying for lifesaving medications or food, local pharmacists and patients are feeling the strain.

"Charges have increased tremendously," said Wole Adeoye, owner of Victory Pharmacy.

The uninsured and those with fixed and low incomes have been among the hardest hit, Adeoye said, and they often make up a large part of the consumer base of independent pharmacies.

Agencies such as Northeast Community Fund and the Salvation Army are available to help a time or two, but even their resources are limited. Adeoye said he often dispenses medication to patients with the hope that they'll eventually scrape together enough to pay him later.

"Some business principles, you have to almost violate it to do the human part of it," Adeoye said. "¦ It's not a typical business. It's a business that you have to care for your customer. You have to be concerned. You have to have empathy for them. You have to take care of them the best way you know how."

Dale Colee, owner of Dale's Southlake Pharmacy, also has seen the current state of the economy affecting his customers. Most affected, he said, are the seniors.

Colee has noticed an increase in key services the pharmacy offers, including temporary store charge accounts. More customers are using the accounts, and some aren't paying on time.

"Ten percent (of the accounts) pay us late, but they still end up paying us," Colee said.

This slow payment has had little effect on the pharmacy, though the prescriptions filled at the location are increasing. Also increasing is another service the pharmacy provides.

Andrea Liming, full-time patient advocate, spends a lot of time sitting down with customers.

"Many people just don't realize the number of options they have," Liming said.

Liming and Colee often help patients by recommending generic medications to their clients instead of brand-name ones. They also will call doctors or insurance companies, as needed, to validate whether the customer can take the generic forms.

Liming also will explain pamphlets and fill out forms for the customers. The most hectic time for this is in November and December, when people are receiving notifications to enroll in Medicare and Medicaid.

"We have a lot of people that will ask us to help them fill out a form, which, of course, we will," Liming said.

Pharmacy workers also try to direct people toward other sources if they cannot help. Liming has called First Call For Help, a service offered by United Way, for customers. The customers can call this service themselves, if needed. First Call offers a variety of resources for people who need health or human services, including health insurance programs and medical information lines.

A second source of financial burden on local pharmacies, Adeoye said, are pharmacy benefit managers, the third-party companies that manage Medicare Part D.

"They delay making payments," he said. "Medicare takes 60 to 90 days to pay, so you can see the pressure that is on independent pharmacies."

Adeoye voiced his support for a current U.S. Senate bill, Medicare Improvements for Patients and Providers Act of 2008, that he hopes will guarantee prompt payment for community pharmacies. The bill, S 3101, provides for a standard time limit for reimbursements on valid claims under Medicare Part D and a delay on the implementation of average manufacturer price reimbursement changes under Medicaid.

"Pharmacy has never been aggressive when it comes to political action," Adeoye said. "And now we realize that if we don't, it could be bad for the business and, therefore, for any community, especially for the elderly and then in the rural areas …"

Helen Scheibly's primary income comes from Social Security. The 69-year-old woman is on nine medications for high blood pressure and heart troubles.

Last year, the actual cost of Scheilby's medication without co-pays was $5,845. Scheilby is enrolled in Illinois Care and Medicare Part D. This year, her Medicare monthly premium is paid by Illinois Care. Illinois Care also allows for co-pay of her medications. She pays a co-pay of $2.25 for generics and $5.50 for her brand-name medicines.

This month, she has reached her limit. She has yet to know how much her medication will cost for this month.

Sandra Siler, 54, of Sullivan sought help from the pharmaceutical companies themselves. Siler, who is uninsured, lives with chronic back problems, degenerative disk disease, diabetes, arthritis and osteoporosis. She takes 10 medications.

Siler registered at an event in April for assistance programs through the Partnership for Prescription Assistance, created three years ago by the Pharmaceutical Research and Manufacturers of America. The four prescriptions she gets for free through the partnership would run her at least $600 a month, she said.

Siler gets her six other prescriptions filled at Wal-Mart and spends about $77 for all when she orders a three-month supply.

Siler's husband, David, 57, is insured through the U.S. Department of Veterans Affairs because of his military service. He had his fourth heart attack in April.

"I told him, I said, 'You can't die because I don't know what I'd do without you,' " Sandra Siler said.

Now the couple lives on $1,100 a month through her Social Security disability and her late former husband's pension.

Both Sandra Siler, who is unable to stand for long periods or walk comfortably, and her husband are unable to work. She went on short-term temporary disability leave from her job at Ampad in Mattoon after she broke her elbow but was cut off after four months. The couple lived off savings until the first Social Security check came several weeks ago.

Life without these sources of help would present a dilemma.

"I would either do without or have to pick and choose which ones I would take or which ones I needed the worst." Siler said. "I anticipated this a long time ago after I broke my elbow and I tried to go off of some of my medication to try to figure out how I was going to feel if I didn't take it. I couldn't walk. I couldn't move. I was in bed for three days until I started taking my medicine again."

Siler said she's grateful for the help the partnership provides.

"When you're between a rock and a hard spot, between not working and not having insurance and Medicare, you need something in there to help you," Siler said.

Annie Getsinger can be reached at 421-6968 or agetsinger@herald-review.com. Kristy Mellendorf can be reached at kmellendorf@herald-review.com or 421-6977.