Community Pharmacy Medicare Part D Consultations: Plan-Switching Decisions and Chronic Medication Adherence

Abstract

Objectives: (1)To compare Part D plan switching for users and nonusers of a pharmacy-led Medicare Part D consultation service and (2) to evaluate the effect of service use on chronic medication adherence. Methods: This was a longitudinal study, occurring in one independently owned community pharmacy in Iowa. Medicare Part D beneficiaries who used the service were compared to nonusers. Dispensing data were used to compare planswitching and the effect of service use on chronic medication adherence between service users and nonusers. Proportion of days covered (PDC) was used to evaluate medication adherence. Results: In the 2017 and 2018 plan year, 79 and 138 Medicare beneficiaries used the service, respectively. These individuals were compared to 849 Medicare beneficiaries and a random sample of 101 beneficiaries in respective years. The respective switching rates for service users in 2018 and 2019 plan year were 43% and 15.9%, compared to 4% switching rates in both years for nonusers. Using the Medicare Part D consultation yielded a statistically significant positive effect on switching in both plan years ( P values < .05) and a statistically significant positive effect on PDC between years ( P value <.05). Conclusion: The use of a pharmacist-led Medicare Part D consultation resulted in increased plan switching and improved chronic medication adherence.

Cost-Savings and Patient Experience with a Pharmacy-Led Medicare Part D Consultation Service

“…Based on previous evaluations of this patient population, the Medicare Part D plan switching rate for individuals who used the Medicare Part D consultation service in 2018 was 43%. 6 While the 2018 switching rate for individuals who used the service was considerably higher than those that did not (43% for service users compared to 4% for nonusers) 6 , many patients who used the service still may have been uncertain about their plan-switching decision.…”

“…As previously reported, only 43% of individuals who used this service actually switched plans in 2018. 6 While a large percentage of service users may have had an opportunity to decrease OOP costs, some patients chose not to switch plans. From these results, satisfaction, service importance, and potential cost-savings alone may not be enough to mobilize all patients to a plan switching decision, despite potential benefits.…”

“…The pharmacy provided deidentified dispensing data for all of 2017 and 2018. As this was a part of a larger analysis 6 , a small subset of patients was included in the cost savings calculation and had to meet a number of inclusion criteria. First, a current 2018 Medicare Part D plan needed to be clearly identifiable.…”

“…3 Community pharmacies currently offering Medicare Part D consultation services have the ability to help patients with their Medicare Part D plan selection, informing plan-switching decisions resulting in lower OOP costs and increased medication adherence. 3 , 5 , 6 …”

Using journey mapping to understand the patient experience with selecting a Medicare part D plan using a pharmacy consultation service

“…Pharmacy-led Medicare Part D consultation services have been shown to increase Medicare Part D plan-switching behavior, patient OOP cost-savings, and chronic medication adherence. 6 , 7 , 8 , 9 Focusing on explanations of medical or drug benefits, Medicare Part D plan comparison, and screening patients for plan eligibility, pharmacy-led Medicare Part D consultation services may be an effective way of improving the beneficiary experience with selecting a Medicare Part D plan. 10 Despite potential benefits and the increasing availability of pharmacy-led Medicare Part D consultation services, it appears that few patients repeatedly use these services despite positive service experiences and high levels of satisfaction.…”