Impact of student pharmacist interventions on Medicare Part D beneficiaries' out-of-pocket prescription drug plan costs

BACKGROUND: Given the complexity of the Medicare Part D (“Part D”) prescription drug benefit, many low-income and other vulnerable groups of beneficiaries lack knowledge and experience to select optimal prescription drug plans. Because of their clinical training and knowledge of drug therapy, pharmacists are uniquely qualified to act as patient advocates for these beneficiaries. To enable such advocacy, we developed and implemented didactic and problem-based learning curricular innovations designed to enhance student pharmacists' knowledge of Part D, attitudes toward patient advocacy, and ability to use the web-based Medicare Prescription Drug Plan Finder tool to select the best plan for individual beneficiaries. OBJECTIVE: Through community outreach events targeted at underserved populations, we determined the impact of student pharmacists' interventions on beneficiaries' total out-of-pocket prescription drug plan costs (premiums, deductibles, co-payments, etc.). METHODS: Student pharmacists from five California pharmacy schools received training to provide Part D consultations to beneficiaries during community outreach events in 2007 and 2008. Demographic and insurance information was collected from each beneficiary via survey. Prescription drug plan costs for their current (2007) plan and lowest identified cost plan for 2008 were obtained using the Plan Finder tool. Total time for each intervention was recorded. RESULTS: Data were collected on 208 beneficiaries. The mean ± SD age of the participants was 73.96 ± 9.30 years, and 85 (40.9%) were male. The mean ± SD (range) number of prescription drugs per participant was 5.19 ± 3.34 (0-19). Eighty-three patients (39.9%) had limited or no English proficiency; 75 (36.1%) had less than a high school education; and 99 (47.6%) were enrolled in both Medicare and Medicaid. Data from 74 participants who were not enrolled in Part D 2007 or who had incomplete data) were excluded from the analysis. For the other 134 beneficiaries, the mean ± SD time for completion of the intervention was 42.51 ± 25.43 minutes. The mean ± SD annual cost savings for changing to the lowest-cost Medicare Part D prescription drug plan for 2008 was $329.10 ± $552.81, for total mean ± SD (range) annual cost savings per minute of $10.40 ± $19.75 ($0 - $119.75). CONCLUSIONS: Trained student pharmacists can provide community-based interventions resulting in cost savings to the underserved Medicare population. The success of this intervention, which would be substantially shortened when conducted by licensed professional pharmacists outside of a formal research project, suggests potential benefits if implemented in community health clinics and pharmacies.