Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D
Abstract
:1. Introduction
2. Materials and Methods
- Financial Performance of Pharmacy since 2006
- Considerations regarding the sale of the pharmacy
- Providing Medication Therapy Management
- Concerns about Part D 2010 Updates
3. Results
3.1. Survey Responses
3.2. Financial Performance Since 2006
3.3. MTM Services
3.4. Part D 2010 Updates
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Total (n = 419) | Rural (n = 84) | Suburban (n = 163) | Urban (n = 131) | |
---|---|---|---|---|
Male | 60.5% | 53.6% | 60.7% | 64.6% |
Age (>40 years) | 80.4% | 76.2% | 81.5% | 81.7% |
Primary Region of Practice (via US Census Bureau designation) | ||||
Northeast | 16.6% | 27.3% | 16.9% | 7.8% |
Midwest | 31.9% | 35.1% | 29.2% | 35.9% |
South | 39.5% | 28.6% | 40.9% | 44.5% |
West | 11.9% | 9.1% | 13.0% | 11.7% * |
Primary Type of Practice Site | ||||
Independent (1 store to 3 stores) | 56.6% | 51.8% | 49.4% | 71.8% |
Chain (≥4 stores) and Other § | 43.4% | 48.2% | 50.6% | 28.2% ** |
Work Status (Full-Time) | 82.0% | 82.1% | 80.1% | 83.9% |
Work Status (Part-Time 30 h or less) | 18.0% | 17.9% | 19.9% | 16.1% |
Terminal Degree | ||||
Doctor of Pharmacy | 26.9% | 29.3% | 25.5% | 26.7% |
Bachelor of Science | 69.9% | 64.6% | 71.4% | 71.8% |
Other | 3.2% | 6.1% | 3.1% | 1.5% |
Primary Role as a Pharmacist | ||||
Staff Pharmacist | 40.1% | 40.5% | 52.8% | 22.1% |
Pharmacist-in-Charge/Pharmacy Manager/Part of Upper Level Pharmacy Management (District Manager)/Other | 37.9% | 40.5% | 34.4% | 41.2% |
Community Pharmacy Part-Owner/Owner | 22.0% | 19.0% | 12.9% | 36.6% *** |
Years of community pharmacy practice as a Registered Pharmacist | ||||
15 years or less | 25.6% | 36.9% | 24.4% | 19.2% |
More than 15 years | 74.4% | 63.1% | 75.6% | 80.8% **** |
Number of prescription dispensed in a typical day | ||||
0 to 300/weekday | 67.1% | 71.4% | 59.9% | 73.8% |
>300/weekday | 32.9% | 28.6% | 40.1% | 26.2% |
>50% of patients enrolled in Medicare Part D | 29.4% | 38.6% | 25.8% | 28.2% ***** |
Percentage of prescriptions received electronically | ||||
Zero | 1.1% | 0 | 0.6% | 2.3% |
1% to 25% | 32.3% | 27.4% | 29.4% | 38.9% |
26% to 50% | 44.4% | 51.2% | 45.4% | 38.9% |
>50% | 22.2% | 21.4% | 24.5% | 19.8% |
Factor | Odds Ratio | 95% CI | P value |
---|---|---|---|
Primary Practice Site * | 1.84 | 1.10 to 3.08 | 0.0211 |
Primary Practice location ** | |||
Rural | 0.75 | 0.40 to 1.42 | 0.3834 |
Suburban | 0.86 | 0.50 to 1.49 | 0.5900 |
Number of years in community practice | 0.64 | 0.38 to 1.07 | 0.0892 |
Percentage of Part D patients | 0.88 | 0.53 to 1.46 | 0.6116 |
Percentage of Prescriptions Received Electronically *** | |||
1% to 25% | 0.06 | 0.00 to 0.80 | 0.0329 |
26% to 50% | 0.10 | 0.01 to 1.33 | 0.0812 |
>50% | 0.06 | 0.00 to 0.81 | 0.0343 |
Primary Role **** | |||
Pharmacist-in-charge, Pharmacy Manager, Part of Upper Level Management and Other | 0.65 | 0.39 to 1.09 | 0.1013 |
Community Pharmacy Owner and Part-Owner | 0.38 | 0.18 to 0.79 | 0.0090 |
Prescription Volume † | |||
100 to 300 per weekday | 2.08 | 0.78 to 5.54 | 0.1421 |
301 to 500 per weekday | 2.95 | 1.02 to 8.58 | 0.0465 |
>500 per weekday | 3.30 | 1.08 to 10.02 | 0.0356 |
All | Rural | Suburban | Urban | |
---|---|---|---|---|
Primary region of practice * | ||||
Northeast | 13 (14.9%) | 5 (38.5%) | 5 (23.8%) | 1 (2.1%) |
Mid-West | 26 (29.9%) | 3 (23.1%) | 8 (38.1%) | 14 (29.2%) |
South | 42 (48.3%) | 4 (30.8%) | 7 (33.3%) | 29 (60.4%) |
West | 6 (6.9%) | 1 (7.7%) | 1 (4.8%) | 4 (8.3%) |
Percent of prescriptions received electronically ** | ||||
None | 2 (2.2%) | 0 | 0 | 2 (4.2%) |
1% to 50% | 71 (79.8%) | 14 (87.5%) | 12 (57.1%) | 42 (87.5%) |
>50% | 16 (18.0%) | 2 (12.5%) | 9 (42.9%) | 4 (8.3%) |
Pharmacy’s financial performance since 2006 *** | ||||
Excellent | 1 (1.2%) | 0 | 0 | 1 (2.1%) |
Good | 17 (19.8%) | 2 (12.5%) | 3 (14.3%) | 12 (25.0%) |
Average | 35 (40.7%) | 2 (12.5%) | 13 (61.9%) | 20 (41.7%) |
Below average | 29 (33.7%) | 10 (62.5%) | 5 (23.8%) | 13 (27.1%) |
Poor | 4 (4.7%) | 2 (12.5%) | 0 | 2 (4.2%) |
Prescription volume dispensed (past 2 years prior to survey completion) **** | ||||
Decreased | 30 (33.3%) | 8 (50.0%) | 4 (20.0%) | 15 (33.3%) |
Increased | 39 (43.3%) | 7 (43.8%) | 7 (35.0%) | 20 (44.4%) |
Remained the same | 21 (23.3%) | 1 (6.3%) | 9 (45.0%) | 10 (22.2%) |
Provide MTM which is reimbursed by at least one Part D plan ***** | 55 (64.0%) | 6 (37.5%) | 13 (65.0%) | 34 (75.6%) |
Number of prescription dispensed in a typical day of practice ****** | ||||
0 to 300/weekday | 63 (75.0%) | 8 (50.0%) | 16 (76.2%) | 39 (83.0%) |
>300/weekday | 21 (25.0%) | 8 (50.0%) | 5 (24.8%) | 8 (17.0%) |
Considerations regarding the sale of the pharmacy | ||||
Respondent considering sale of the pharmacy | 38 (44.7%) | 5 (31.3%) | 8 (40.0%) | 24 (51.1%) |
The decision to sell is influenced by the financial pressure exerted by Part D | 32 (94.1%) | 5 (100%) | 6 (75.0%) | 20 (83.3%) |
Considering sale and have identified a potential buyer | 14 (36.8%) | 1 (20.0%) | 4 (50.0%) | 8 (33.3%) |
Another community pharmacy located within 1 to 10 mile radius of the pharmacy considered for sale | 33 (86.8%) | 5 (100%) | 7 (87.5%) | 20 (83.3%) |
Do You Provide MTM Reimbursed by at Least one Part D Plan at Your Primary Practice Site? | ||
---|---|---|
Yes | No | |
All | 220 (57.3%) | 164 (42.7%) |
Geographic location | ||
Rural | 50 (59.5%) | 34 (40.5%) |
Suburban | 88 (54.0%) | 75 (46%) |
Urban | 79 (60.3%) | 52 (39.7%) |
Age (≤40 years) | 57 (26.3%) | 17 (10.6%) |
Age (>40 years) * | 160 (73.7%) | 143 (89.4%) |
Years of community pharmacy practice ** | ||
15 years or less | 67 (31.0%) | 29 (18.2%) |
More than 15 years | 149 (69.0%) | 130 (81.8%) |
For the past 2 years, volume of prescription dispensed has *** | ||
Increased | 98 (48.3%) | 53 (33.5%) |
Remained the same | 62 (30.5%) | 55 (34.8%) |
Decreased | 43 (21.2%) | 50 (31.6%) |
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Khan, S.; Spooner, J.J.; Spotts, H.E. Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D. Pharmacy 2018, 6, 67. https://doi.org/10.3390/pharmacy6030067
Khan S, Spooner JJ, Spotts HE. Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D. Pharmacy. 2018; 6(3):67. https://doi.org/10.3390/pharmacy6030067
Chicago/Turabian StyleKhan, Shamima, Joshua J. Spooner, and Harlan E. Spotts. 2018. "Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D" Pharmacy 6, no. 3: 67. https://doi.org/10.3390/pharmacy6030067
APA StyleKhan, S., Spooner, J. J., & Spotts, H. E. (2018). Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D. Pharmacy, 6(3), 67. https://doi.org/10.3390/pharmacy6030067