Medicare Part D: Pharmacists and formularies--whose job is it to address copays?

Objective: To explore pharmacists' perceived responsibility to assist Part D patients in the community in managing their out-of-pocket (OOP) costs as well as pharmacists' overall experience with Medicare Part D.

Design: Cross-sectional analysis.

Setting: Maine, New Jersey, New York, Massachusetts, Maryland, and Pennsylvania.

Participants: 272 pharmacists.

Intervention: 37-question online survey.

Main Outcomes: Perceived responsibility to assist Part D patients in managing their OOP costs and pharmacists' overall experience with Medicare Part D.

Results: Of the 4,888 online surveys, 1,108 were assumed to have reached the intended recipients, of which 272 responded (adjusted response rate 25.0%). Fifty-seven percent, 43.3%, and 41.9% of pharmacists reported that it was not their responsibility to address Part D patients' copayment/cost issue, prior authorization issues, or dispense preferred formulary medications, respectively. However, 43.2% reported that their most time-consuming task in reference to Part D were addressing formulary and copayment issues. In reference to overall experience with Part D, 42.9% reported that the impact on pharmacy's workflow was negative or very negative. A significant difference was observed between pharmacists' practice settings, the state in which they practiced, and reporting of negative impact of Part D on workflow (χ² = 4.9, P = 0.028; χ² = 6.16, P = 0.013, respectively).

Conclusion: Most community pharmacists reported that it was not their responsibility to address patients' OOP costs issues, though a majority reported that the most time-consuming task in reference to Part D was addressing formulary and copayment issues. Almost half of the pharmacists also reported that the impact of Part D on workflow was negative.