Clinical Ophthalmology (Apr 2024)
Improved Glaucoma Medication Access Through Pharmacy Partnership: A Single Institution Experience
Abstract
Jin G Choi,1,2 Pathik Amin,3 Alaina Tarantino,4 Mary Qiu3 1Pritzker School of Medicine, University of Chicago, Chicago, IL, USA; 2Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; 3Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA; 4Ambulatory Pharmacy Services, University of Chicago, Chicago, IL, USACorrespondence: Mary Qiu, Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA, Tel +1 (773) 702-3937, Email [email protected]: A major barrier to glaucoma medication adherence is the patient’s out-of-pocket costs. At the University of Chicago Medical Center (UCMC), the institutional pharmacy piloted a program to query out-of-pocket costs for each patient’s medication list based on their insurance coverage. This study aims to describe the impact of this collaboration between the glaucoma service and the outpatient pharmacy service.Methods: This study is a single institution, retrospective chart review of glaucoma patients with a formulary inquiry placed by a single glaucoma specialist between 4/1/2020 and 2/28/2022. Main outcome measures included medications before and after formulary inquiries, additional steps required to access the medications (ie, formulary exceptions, prior authorizations, tier exceptions), and out-of-pocket costs.Results: A total of 343 formulary inquiries, representing 568 individual medication inquiries, were conducted. Out of the 568 medication inquiries, only 78 could be filled for an affordable price without any additional steps. For 45 inquiries, additional steps were required for the medication to become covered at an affordable price. The remaining 445 inquires required additional steps with subsequent denial or prohibitive out-of-pocket costs.Conclusion: The UCMC workflow provided transparent out-of-pocket costs for patients to access glaucoma medications. This workflow may be cost-effective as it minimizes the burden on the overall system by reducing the number of patients who are unable to fill a prescription at the pharmacy due to issues with coverage or affordability. This model of physician-pharmacy collaboration can guide other institutions to implement similar workflows which directly mitigate costs and improve quality of care.Keywords: medication, access, cost
