(Management Case Study) Financial and Readmission Impact of a Pharmacy-Led Medication Access Barriers Program

Purpose: Cost-related Medication Nonadherence (CRMN) poses a fundamental challenge for both medical providers and patients. The Medication Management Clinic in collaboration with Anchor Pharmacy recognized the need for a targeted service that addresses the financial burden elderly patients face when it comes to accessing medications. To address this issue, a targeted program was developed in collaboration with an outpatient pharmacy to resolve CRMN to ensure long-term access to medications. The aim of this project was to demonstrate the impact of addressing access barriers to medication adherence on financial savings to patients and readmissions.

Methods: This was a retrospective, non-randomized, and single center program. It included all patients discharged from Carroll Hospital Center from January to December 2021. Each patient with identified financial challenge to adherence was referred to the Medication Management Clinic. The Pharmacists reviewed each patient for prescription insurance status (uninsured, underinsured, Medicare, Medicaid, or commercial) and determined the most appropriate solution for long-term access without delaying discharge. Based on patient need, one of the following solutions were implemented; a manufacture coupon, prescription assistance application, or a voucher coverage for immediate access to medication.

Results: The program saved $503,858 to patients on prescription medications with a median readmission rate of 1.93%(1.25,2.31) for this cohort. The manufacturer prescription assistance program saving accounted for 97% ($488,750) of the total dollars saved by the program. The voucher program's total expenditure during the time frame was $15,108; accounting for 2.99% of the dollars saved to the community. Interestingly, our results show that 69.5% ($352,471) of the dollars saved to patients was between the months of August to December 2021.

Conclusion: A program that targets cost-related medication nonadherence has the potential to decrease medication-related readmissions and alleviate financial burden of healthcare cost to patients. Based on the results of this program, we can infer that targeted programs such as these are beneficial to institutional goals of decreasing medication related readmission secondary to nonadherence.