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Medicare Part D: Pharmacists and Formularies—Whose Job is it to Address Copays?

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Objective: To explore pharmacists' perceived responsibility to assist Part D patients in the community in managing their out-of-pocket (OOP) costs as well as pharmacists' overall experience with Medicare Part D.

Design: Cross-sectional analysis.

Setting: Maine, New Jersey, New York, Massachusetts, Maryland, and Pennsylvania.

Participants: 272 pharmacists.

Intervention: 37-question online survey.

Main Outcomes: Perceived responsibility to assist Part D patients in managing their OOP costs and pharmacists' overall experience with Medicare Part D.

Results: Of the 4,888 online surveys, 1,108 were assumed to have reached the intended recipients, of which 272 responded (adjusted response rate 25.0%). Fifty-seven percent, 43.3%, and 41.9% of pharmacists reported that it was not their responsibility to address Part D patients' copayment/cost issue, prior authorization issues, or dispense preferred formulary medications, respectively. However, 43.2% reported that their most time-consuming task in reference to Part D were addressing formulary and copayment issues. In reference to overall experience with Part D, 42.9% reported that the impact on pharmacy's workflow was negative or very negative. A significant difference was observed between pharmacists' practice settings, the state in which they practiced, and reporting of negative impact of Part D on workflow (χ² = 4.9, P = 0.028; χ² = 6.16, P = 0.013, respectively).

Conclusion: Most community pharmacists reported that it was not their responsibility to address patients' OOP costs issues, though a majority reported that the most time-consuming task in reference to Part D was addressing formulary and copayment issues. Almost half of the pharmacists also reported that the impact of Part D on workflow was negative.
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Keywords: COPAYMENT; COPAYS; FORMULARY; MEDICARE; MEDICARE PART D; OUT-OF-POCKET COSTS; PHARMACISTS; PRIOR AUTHORIZATION; WORKFLOW

Document Type: Research Article

Affiliations: Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, Springfield, Massachusetts, USA

Publication date: 2014-09-01

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  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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