Masuda Camlyn, Huynh Tony, Wong Veronica, DeJong Colette, Tseng Chien-Wen
Department of Pharmacy Practice, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI 96720, USA.
Department of Medicine, University of California, San Francisco, CA 94143, USA.
Pharmacy (Basel). 2022 Jan 27;10(1):23. doi: 10.3390/pharmacy10010023.
Pharmacists must be able to navigate prescription drug coverages to help providers and patients reduce out-of-pocket costs. Traditionally, curricula on drug insurance benefits rely on lectures and lack a practicum that offers students hands-on experience with determining formulary and cost-sharing information. An activity for pharmacy students to update a free public website that summarizes formularies and copayment requirements across major insurers was piloted. Pharmacy students were trained to locate online formularies and identify a drug's coverage tier, step therapy, prior authorization, and cost-sharing during a 6-week experiential rotation. Students checked formularies from six insurance plans for 250-plus drugs across 15 health conditions. Graduates were surveyed (74% response rate) about the activities' impact on their learning and ability to navigate drug benefits. Respondents rated the training as helpful in learning whether a drug was covered (100%), or required step therapy or prior authorization (100%). The majority of graduates reported being able to look up formulary coverage (90%), step therapy or prior authorization (90%), and copayment requirements (65%). Our innovative skills-based pilot activity was effective in teaching pharmacy students to navigate insurance formularies, which is essential for helping patients access medications.
药剂师必须能够掌握处方药保险范围,以帮助医疗服务提供者和患者降低自付费用。传统上,药品保险福利课程依赖讲座,缺乏能让学生亲身体验确定处方集和费用分摊信息的实践环节。一项针对药学专业学生更新免费公共网站的活动进行了试点,该网站汇总了各大保险公司的处方集和共付要求。在为期6周的体验式轮转中,药学专业学生接受培训,以查找在线处方集,并确定药物的保险层级、逐步治疗、预先授权和费用分摊情况。学生们检查了六种保险计划针对15种健康状况下250多种药物的处方集。对毕业生进行了调查(回复率为74%),了解这些活动对他们学习以及掌握药物福利相关能力的影响。受访者认为该培训有助于了解药物是否在保险范围内(100%),或是否需要逐步治疗或预先授权(100%)。大多数毕业生表示能够查询处方集覆盖范围(90%)、逐步治疗或预先授权(90%)以及共付要求(65%)。我们基于技能的创新试点活动有效地教会了药学专业学生掌握保险处方集,这对于帮助患者获得药物治疗至关重要。