title: Patient acceptability of and readiness-to-pay for pharmacy-based health membership plans to improve hypertension outcomes in Lima, Peru.
abstract: Pharmacies have been used to improve population health in Peru and other countries globally, operating as a non-traditional health access point. A pharmacy-based model holds potential to improve patient management of hypertension, a leading risk factor for non-communicable diseases in low- and middle-income countries. The aim of this study was to evaluate patient acceptability of hypertension services and health membership plans, if offered through private pharmacies in the future.
  
  
  
  A cross-sectional study was conducted with 347 hypertensive individuals who purchased anti-hypertensive medications in a private pharmacy during the study period (July-October 2012). The study included a brief survey assessing patients' acceptability of and readiness-to-pay for pharmacy-based hypertension management services. Chi-square tests for differences in proportions were used to evaluate whether any demographic characteristics (e.g., binary variables for age, time since diagnosis, and type of medication usually purchased) could identify groups of hypertensive individuals that might be more or less likely to use pharmacy-based services. Multiple logistic regression was used to estimate associations between readiness-to-pay for pharmacy-based health membership plans and patient-level characteristics.
  
  
  
  Over 80% of individuals indicated they would be interested in pharmacy-based hypertension services, particularly discounts on anti-hypertensive medications and free blood pressure screenings. Compared to individuals 65 years of age or older, individuals under 65 years were more interested in receiving at least one pharmacy-based service. Another 80% indicated they would be interested in purchasing a monthly health plan through a pharmacy that provided access to hypertension services each month. The vast majority of individuals interested in pharmacy-based services indicated they would pay ≤$3.69 US/month to participate in a monthly health membership plan.
  
  
  
  Hypertensive patients would be interested in using and ready to pay for pharmacy-based hypertension services.
authors.affiliation: University of Washington, School of Pharmacy, Seattle, WA, USA. Electronic address: evodicka@uw.edu.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Vodicka
authors.affiliation: Universidad Peruana Cayetano Heredia, School of Public Health and Administration, Lima, Peru.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Antiporta
authors.affiliation: Universidad Peruana Cayetano Heredia, School of Public Health and Administration, Lima, Peru.
authors.forename: Yukimi
authors.initials: Y
authors.lastname: Yshii
authors.affiliation: University of Washington, Department of Global Health, Seattle, WA, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Zunt
authors.affiliation: Universidad Peruana Cayetano Heredia, School of Public Health and Administration, Lima, Peru; University of Washington, Department of Global Health, Seattle, WA, USA.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Garcia
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics; D016015:Logistic Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010568:Peru; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration*
chemical_list: D000959:Antihypertensive Agents
keywords: Chronic disease; Hypertension; Low- and-middle income countries; Peru; Pharmacies