Kyle discusses the prescribing trends and policies that emerged in 2020. He highlights the growing importance of pharmacists and the role of technology in improving patient access, affordability, and adherence.
Read more in CoveryMyMeds’ 2021 Medication Access Report: Legislative and Regulatory Edition. (free download)
Read on for Kyle’s insights.
Prescribing and Policy Trends Affecting Medication Access in 2021
By Kyle Grimslid, Pharm.D., Clinical Solutions Director, CoverMyMeds
Patients received longer fills of maintenance medications, visited the pharmacy for testing and vaccination and 70 percent have now had a telehealth appointment, up from 18 percent before COVID-19. (CoverMyMeds COVID-19 Patient Survey, 2020)
With telehealth and virtual medication management in place and federal and state legislation tackling issues such as prescription price control and pharmacy scope of practice, the pharmacy of the future will likely only become more holistically patient-centric
Healthcare technology and policies will need to keep up with the demands of healthcare consumerism.
Below, we examine trends and policies that have shaped the last year and look ahead to solutions currently in motion to create reliable medication access paths in a fluid patient journey.
PRESCRIBING SHIFTS AND PRESCRIPTION MANAGEMENT TRENDS
In 2020, new prescriptions plummeted by as much as 37 percent, compared to 2019 baseline levels. Continuing prescriptions remained fairly stable, only dipping as low as 8 percent during 2020—in part due to relaxed or waived medication regulations for prior authorization (PA) and refill-too-soon orders that allowed patients access to prescribed medications during office closures. (Source)
Prescribing trends varied by condition. Prescriptions to treat mental health increased over 2019 levels, with new prescriptions up by as much as 25 percent in some states. Psychiatrists saw the least impact on diagnostic visits during the COVID-19 pandemic compared to other specialties like rheumatology, where seeing the patient in-person can make a bigger impact on a provider’s diagnosis or treatment plan. (Source)
Medical claims data from 2020 showed prescribers were less willing to initiate new prescriptions remotely, with as much as a 40 percent difference in prescribing volume for in-office visits over telehealth visits.
When it comes to receiving these prescriptions, many more patients have opted to have them sent straight to their door, either through mail order or retail pharmacy home delivery. In September 2019, 88 percent of patients surveyed picked up their prescription at a retail pharmacy. In a year, this number dropped to 50 percent—half of patients surveyed reported receiving prescriptions at home during the previous six months. (CoverMyMeds Patient Survey, 2019, 2020)
Forty-one percent of pharmacists surveyed in 2020 said they’ve started prescription home delivery services since the start of the COVID-19 pandemic. (CoverMyMeds Pharmacist Survey, 2020) Managing medications through apps and patient interfaces is indicative of the rising healthcare consumerism trend, and electronic pharmacy workflows will be critical to keeping up with this demand. While receiving prescriptions at home will likely remain a permanent option for patients, surveys show they rely on their pharmacist as part of their care team more than ever.
SCOPE OF PRACTICE POLICIES COULD HEIGHTEN PHARMACISTS’ IMPACT ON PATIENT CARE TEAM
The COVID-19 pandemic made glaringly obvious the pivotal role pharmacies can play in primary care. Over 40,000 pharmacies nationwide have been part of the federal vaccination effort, contributing to the mass distribution of the COVID-19 vaccine. (See FACT SHEET: President Biden Announces Increased Vaccine Supply, Initial Launch of the Federal Retail Pharmacy Program, and Expansion of FEMA Reimbursement to States, WhiteHouse.gov, 2021)
Due to the COVID-19 pandemic:
- 27% of patients relied more on their pharmacist for information regarding their condition and medication (CoverMyMeds Patient Survey, 2020)
- 18% of patients relied more on their pharmacist to explain benefit and payment options for medications (CoverMyMeds Patient Survey, 2020)
- 70% of pharmacists have taken on new job responsibilities (CoverMyMeds Pharmacist Survey, 2020)
While most pharmacists themselves can order and administer vaccinations, few states allow pharmacists independent provider status to prescribe medications. As patients feel comfortable with their pharmacist, an increased scope of practice could help provide a familiar access channel for medication and primary care.
Most states allow collaborative practice agreements, in which a pharmacist and a physician have an agreement to allow pharmacists some patient care authority such as adjusting medications, prescribing and ordering labs. If granted provider status, pharmacists have the potential to improve patient care through expedited PA, medication changes and lab billing and administration. More than 40 pieces of legislation are currently pending in states regarding pharmacist provider status, ranging from prescriptive authority to COVID-19 medication administration.
To allow for more time to encompass a widening scope of work, in-workflow technology at the pharmacy could help improve efficiencies for the entire patient care team. For example, pharmacists using a solution that provided real-time PA status updates saw an average 14 percent increase in paid claims than those using standard electronic PA request submission methods. (CoverMyMeds data on file, 2020)
The COVID-19 pandemic accelerated the course of healthcare consumerism in prescribing and the ways patients access healthcare. As the pharmacist’s role on the patient care team grows in relevance, technology and policies will need to keep pace.
Read more about regulations and policies directly related to medication access in the 2021 Medication Access Report: Legislative and Regulatory Edition.
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