For families living with epilepsy or seizure disorders in rural Ohio, the moment a seizure begins is not the time to worry about whether a medication is affordable or within reach. Community Health & Wellness Partners (CHWP) has taken a major step to change that reality. 

CHWP has partnered with Nationwide Children’s Hospital (NCH) to become a certified satellite pharmacy, enabling the local dispensing of compounded intranasal midazolam, a fast-acting, affordable seizure rescue medication. Previously, this option was only available through Nationwide Children’s Hospital Outpatient Pharmacies, requiring families to travel to Columbus to access it. 

Intranasal midazolam is sprayed directly into the nose to stop a seizure in progress. It belongs to a class of medications called benzodiazepines, which rapidly calm the brain’s electrical activity. Crucially, caregivers and family members can administer it at home without IV access or medical training, making it a vital first line of response for seizure clusters and prolonged seizures. 

Without a rescue medication on hand, seizures lasting more than five minutes risk progressing to status epilepticus, a medical emergency that can cause hospitalization, long-term neurological damage or death.

“Families are forced into a ‘wait and see’ situation or have to call 911, when early intervention at home could have safely stopped the seizure,” said CHWP Clinical Pharmacy Manager, Sanchita Layton, PharmD. 

Nayzilam, the brand-name version of intranasal midazolam, can cost several hundred dollars per box without insurance. Even with coverage, patients frequently face high copays, prior authorization requirements, or outright denials. Before this partnership, patients without access were left driving to Columbus or Dayton’s children’s hospitals or relying on 911. 

The compounded intranasal midazolam now available through CHWP is covered by Medicaid and many commercial insurance plans. For patients without insurance, CHWP’s 340B program ensures affordable pricing regardless of coverage status, in keeping with the organization’s mission to eliminate barriers for everyone in the community. 

The collaboration traces back to a pharmacy student CHWP hosted through its partnership with The Ohio State University. That student had previously interned at Nationwide Children’s Hospital and introduced CHWP’s pharmacy team to NCH’s midazolam program. He has since graduated and now works as a pharmacist at NCH, and helped bring the program to CHWP. 

Through the satellite pharmacy arrangement, NCH providers can send prescriptions directly to CHWP’s in-house pharmacy. The medication is properly dosed and prepared, and patients pick it up locally from a team they already know. Each patient also receives one-on-one education from a CHWP pharmacist on how and when to use the medication safely. 

“For patients to sit down for education with someone local whom they may already know is an added bonus,” said Layton. “Our goal is to make the process straightforward and supportive from start to finish.” 

Intranasal midazolam is intended for patients with a seizure disorder who are at risk for prolonged seizures or seizure clusters. Patients can speak with their provider at CHWP or Nationwide Children’s Hospital to find out if this medication is appropriate for them. CHWP’s pharmacy team will then coordinate the prescription and provide full education before the patient leaves. 

This collaboration is a clear example of what’s possible when organizations come together with a shared commitment to community health. For CHWP, it reflects the values that have guided the organization since its founding: welcoming patients where they are, eliminating barriers, and delivering care that improves the well-being of the whole person. 

For families managing epilepsy or seizure disorders in Logan County and surrounding communities, it means one less barrier between them and the medication that could make all the difference in an emergency.