Pharmacy Prescription Assistance Program: Evaluation of a Health System Retail Model for Outpatients

Abstract

Background: Access to essential medications remains a challenge, especially among socioeconomically disadvantaged populations. In 2021, 18 million U.S. adults struggled to afford prescribed medications, a problem exacerbated by the prevalence of chronic conditions like diabetes, hypertension, and mental health disorders. The 340B Drug Pricing Program has enabled eligible healthcare organizations to purchase drugs at reduced prices, thus enhancing medication accessibility for financially constrained patients. This study explores the impact of the Retail Pharmacy Prescription Assistance Program within a 340B-eligible health system in addressing this issue. Objective: To evaluate the effectiveness of a Retail Pharmacy Prescription Assistance Program in increasing access to essential medications and reducing financial burden for eligible outpatients within a 340B-eligible health system. Methods: This exploratory study was conducted at a 340B-eligible academic medical center and focused on the implementation of the Retail Pharmacy Prescription Assistance Program (RPPA Program). Eligible patients, already enrolled in the health system’s financial assistance program, were identified, and assessed for additional eligibility for the RPPA Program, ensuring prescriptions were written by internal providers and that patients did not have access to other financial assistance resources. Data collected included patient demographics, medication history, dispensed prescriptions, out-of-pocket patient savings, and pharmacist interventions. Results: During the study, 156 patients were enrolled. About half (51%; n = 79) did not utilize its services due to reasons such as the absence of active prescriptions, prescriptions from external providers, or existing coverage by the patients’ insurance. Of the 563 prescriptions clinically evaluated, 72% (n = 407) were dispensed free of charge to 77 patients, resulting in $13,945 in out-of-pocket patient savings. Of the total prescriptions assessed, 28% (n = 156) were not included on the RPPA Program formulary and were not changed to a RPPA formulary alternative for various reasons, such as a formulary alternative was not available, or the patient opted not to switch to formulary alternatives. Conclusions: The RPPA Program proved effective in reducing financial barriers to accessing essential outpatient medications. While it yielded positive outcomes, the program’s benefit was constrained to a limited patient demographic, underscoring the imperative to expand identification and engagement strategies to include a broader patient population.