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Medical Care:
doi: 10.1097/MLR.0b013e318202a9f2
Brief Report

Promoting Access and Reducing Expected Out-of-Pocket Prescription Drug Costs for Vulnerable Medicare Beneficiaries: A Pharmacist-directed Model

Cutler, Timothy W. PharmD*; Stebbins, Marilyn R. PharmD*; Smith, Amanda R. MPH*; Patel, Rajul A. PharmD, PhD; Lipton, Helene L. PhD*,‡

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Abstract

Background: The Medicare Part D benefit is complicated and may be costly, especially for vulnerable low-income populations where lack of resources and limited English proficiency may be barriers to optimal plan selection.

Objectives: To identify vulnerable Medicare beneficiaries and lower their expected annual out-of-pocket (OOP) prescription drug costs through one-on-one prescription drug plan counseling by pharmacists and trained pharmacy students.

Research Design: Between October 2008 and January 2010, a cross-sectional study was performed throughout California. Using Medicare's Prescription Drug Plan Finder tool, expected annual OOP costs for each beneficiary's current prescription drug plan were compared with the lowest-cost plan.

Subjects: The study sample included vulnerable Medicare beneficiaries with annual incomes ≤300% of the Federal Poverty Level.

Results: There were 1300 vulnerable beneficiaries who received counseling at 94 outreach events. Only 29% of beneficiaries with a stand-alone Part D prescription drug plan were enrolled in the lowest-cost plan. On the basis of counseling recommendations, 390 beneficiaries changed to the lowest-cost Part D plan on site, reducing their expected OOP costs by 68%. Additionally, 72 beneficiaries were identified as eligible for but not receiving low-income subsidy benefits and 55 received assistance with the online application for the subsidy.

Conclusions: Findings show that targeted outreach by trained pharmacy advocates can identify vulnerable Medicare populations in need of Part D counseling and reduce their expected annual OOP prescription drug costs.

© 2011 Lippincott Williams & Wilkins, Inc.

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