title: Potential impact of pharmacist interventions to reduce cost for Medicare Part D beneficiaries.
abstract: The objective was to determine the impact of simulated pharmacist interventions on out-of-pocket cost, time to coverage gap, and cost per patient to the Medicare Part D program using actual patient cases from an adult general medicine clinic. Medication profiles of 100 randomly selected Medicare-eligible patients from a university-affiliated general internal medicine clinic were reviewed by a pharmacist to identify opportunities to cost-maximize the patients' therapies based on the plan. An online Part-D calculator, Aetna Medicare Rx Essentials, was used as the standard plan to determine medication cost and time to gap. The primary analysis was comparison of the patients' pre-review and post-review out-of-pocket cost, time to coverage gap, and cost to Medicare. A total of 65 patients had at least 1 simulated pharmacist cost intervention. The most common intervention was substituting for a less costly generic, followed by substituting a generic for a brand name. Projected patient cost savings was $476 per year. The average time to coverage gap was increased by 0.7 ±1.2 months. This study illustrates that the pharmacists may be able to reduce cost to some patients as well as to the Medicare Part D program.
authors.affiliation: College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Thatcher
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Vanwert
authors.forename: Steven R
authors.initials: SR
authors.lastname: Erickson
mesh_terms: D000368:Aged; D017046:Cost Savings; D003430:Cross-Sectional Studies; D016527:Drug Costs; D057915:Drug Substitution / Q000191:economics; D016568:Drugs, Generic / Q000191:economics; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000191:economics*; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D013997:Time Factors; D014481:United States
chemical_list: D016568:Drugs, Generic