A Nationwide Study of Pharmacists' Perception of the Impact of Medicare Part D on the Pharmacist-Patient Relationship.

BACKGROUND

Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States.

AIMS

To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries.

METHODS

A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013. The 43-item online survey collected information about demographics, implications of Part D on community pharmacy and patients, and beliefs about ideal pharmacy practice.

RESULTS

Pharmacists reported more responsibility to address prior authorization issues (55.3% strongly agree or agree) than dispensing preferred medications (43.5%) or addressing patient copayment issues (38.1%). Predictors of the perceived responsibility to assist patients varied and included practice site, pharmacist age, pharmacy prescription volume, and pharmacy financial performance.

DISCUSSION

Financial concerns continue to be the most significant issue following Part D implementation. The degree to which pharmacists feel responsible for addressing patient Part D concerns is variable and dependent on a variety of factors. Pharmacists who felt a personal responsibility to address patient copayment issues reported a better pharmacy financial performance, a larger increase in prescription volume, and a better pharmacist-patient relationship since Part D implementation.

CONCLUSION

Nationwide, Part D financial concerns remain significant. Pharmacists can assist patients with managing cost issues, which can help alleviate pharmacy financial concerns. Many pharmacists practicing at independent locations do not feel responsible for addressing patient cost concerns, which may inadvertently impart a negative financial effect upon their pharmacy.