Medicare Part D: Pharmacists and formularies--whose job is it to address copays?

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.