Willingness to pay for community pharmacies-based medication review service: perspectives of private health insurance firms
Main Article Content
Keywords
medication review, pharmaceutical care, healthcare, health service, Community pharmacy, health insurance, third-party administration
Abstract
Background: The medication review service (MRS) is a valuable community pharmacies-based health service to patients, ensuring optimal medication use and reducing medication errors. Nevertheless, it remains limited in scope and empowerment without remuneration for providing the service. Objective: This study aimed to assess private health insurance (PHI) and third-party administration (TPA) firms' perspectives regarding the MRS offered by community pharmacies in Jordan and the extent of their willingness to pay for this service. Method: The research was an observational, cross-sectional study conducted using a constructed and validated Arabic questionnaire that was distributed electronically to the key health insurance decision-makers (general managers, operational managers, medical network managers, directors, and supervisors) among all the (22) PHI and TPA active firms that are members of the Jordan Insurance Federation (JIF) and licensed under the insurance administration in the Ministry of Industry and Trade. Participants provided their consent electronically before filling out the questionnaire. Results: 50 health insurance decision-makers agreed to participate in this study. 48% partially (42%) or completely (6%) heard about the medication review service. Most respondents (n=35, 70%) believed the medication review service is expected to reduce the cost of medications. Furthermore, they believed the service is expected to reduce the cost of the medical bill by ensuring the medication is not repeated within a short time unless advised by the doctor, checking the exact dosage regimen of each drug, and using alternative medicines at lower cost (74%, 64%, and 60%) of respondents respectively. Half of the respondents were eager to remunerate for the medication review service, with the majority willing to pay less than 10 Jordanian Dinars (JODs) per patient. Conclusion: Although almost half of the PHI and TPA firms' decision-makers had not heard about the MRS before, achieving eventual cost savings in the reimbursed medication value strongly motivated them to reimburse for the service. Pharmacy and health policymakers are in place to take further steps to empower the service and find common ground with insurance parties to reimburse it for improved medical health insurance services to their beneficiaries with overall cost savings.
References
2. Tuula A, Volmer D, Jõhvik L, et al. Factors Facilitating and Hindering Development of a Medication Use Review Service in Eastern Europe and Iran-Cross-Sectional Exploratory Study. Healthcare. 2021;9(9):1207. https://doi.org/10.3390/healthcare9091207
3. Organization, W. H. Medication safety in polypharmacy: technical report; World Health Organization; 2019. Available from: https://www.who.int/publications/i/item/medication-safety-in-polypharmacy-technical-report. Accessed September 10, 2022.
4. Basheti IA, Tadros OKI, Aburuz S. Value of a Community-Based Medication Management Review Service in Jordan: A Prospective Randomized Controlled Study. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2016;36(10):1075-1086. https://doi.org/10.1002/phar.1833
5. Smith M, Cannon-Breland ML, Spiggle S. Consumer, physician, and payer perspectives on primary care medication management services with a shared resource pharmacists network. Research in Social and Administrative Pharmacy. 2014;10(3):539-553.
https://doi.org/10.1016/j.sapharm.2013.08.003
6. Griese-Mammen N, Hersberger KE, Messerli M, et al. PCNE definition of medication review: reaching agreement. International Journal of Clinical Pharmacy. 2018;40(5):1199-1208. https://doi.org/10.1007/s11096-018-0696-7
7. Stewart D, Whittlesea C, Dhital R, et al. Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures. Research in Social and Administrative Pharmacy. 2020;16(2):111- 122. https://doi.org/10.1016/j.sapharm.2019.04.010
8. Geurts MME, Talsma J, Brouwers JRBJ, et al. Medication review and reconciliation with cooperation between pharmacist and general practitioner and the benefit for the patient: a systematic review. Br J Clin Pharmacol. 2012;74(1):16-33. https://doi. org/10.1111/j.1365-2125.2012.04178.x
9. Bechtol R, Pinto, Partha G, et al. Improving the economic and humanistic outcomes for diabetic patients: making a case for employer-sponsored medication therapy management. ClinicoEconomics and Outcomes Research. Published online April 2013;5:153. https://doi.org/10.2147/ceor.s40735
10. Malet-Larrea A, Goyenechea E, García-Cárdenas V, et al. The impact of a medication review with follow-up service on hospital admissions in aged polypharmacy patients. Br J Clin Pharmacol. 2016;82(3):831-838. https://doi.org/10.1111/bcp.13012
11. Dalton K, Byrne S. Role of the pharmacist in reducing healthcare costs: current insights. Integrated Pharmacy Research and Practice. 2017; Volume 6:37-46. https://doi.org/10.2147/iprp.s108047
12. MacKeigan LD, Ijaz N, Bojarski EA, et al. Implementation of a reimbursed medication review program: Corporate and pharmacy level strategies. Research in Social and Administrative Pharmacy. 2017;13(5):947-958. https://doi.org/10.1016/j. sapharm.2017.03.057
13. EYH, Wang KN, Sluggett JK, et al. Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review. Australasian Journal on Ageing. 2019;38(S2):9-25. https://doi.org/10.1111/ajag.12676
14. Jaber D, Aburuz S, Hammad EA, et al. Patient’s attitude and willingness to pay for pharmaceutical care: An international message from a developing country. Research in Social and Administrative Pharmacy. 2019;15(9):1177-1182. https://doi. org/10.1016/j.sapharm.2018.10.002
15. Veiga P, Cavaco AM, Lapão LV, et al. Self-medication consultations in community pharmacy: an exploratory study on teams’ performance, client-reported outcomes and satisfaction. Pharmacy Practice. 2021;19(1):2138. https://doi.org/10.18549/ pharmpract.2021.1.2138
16. Imfeld-Isenegger TL, Soares IB, Makovec UN, et al. Community pharmacist-led medication review procedures across Europe: Characterization, implementation and remuneration. Research in Social and Administrative Pharmacy. 2020;16(8):1057-1066.
https://doi.org/10.1016/j.sapharm.2019.11.002
17. Abu Assab M, Alhamad H, Almazari I, et al. Barriers to Medication Review Process Implementation—Cross-Sectional Study among Community Pharmacists in Jordan. Healthcare. 2022;10(4):651. https://doi.org/10.3390/healthcare10040651
18. Sommers BD, Gunja MZ, Finegold K, et al. Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act. JAMA. 2015;314(4):366. https://doi.org/10.1001/jama.2015.8421
19. Simon K, Soni A, Cawley J. The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions. Journal of Policy Analysis and Management. 2017;36(2):390-417. https://doi. org/10.1002/pam.21972
20. Cuadrado C, Crispi F, Libuy M, et al. National Health Insurance: A conceptual framework from conflicting typologies. Health Policy. 2019;123(7):621-629. https://doi.org/10.1016/j.healthpol.2019.05.013
21. Fasseeh A, ElEzbawy B, Adly W, et al. Healthcare financing in Egypt: a systematic literature review. Journal of the Egyptian Public Health Association. 2022;97(1). https://doi.org/10.1186/s42506-021-00089-8.
22. Sasai Y, Suzuki Y, Takeuchi Y. An analysis of the current condition of the medical insurance system in Japan. Journal of Oral Science. 2019;61(3):481-482. https://doi.org/10.2334/josnusd.19-0198
23. Sriram S, Khan MM. Effect of health insurance program for the poor on out-of-pocket inpatient care cost in India: evidence from a nationally representative cross-sectional survey. BMC Health Services Research. 2020;20(1). https://doi.org/10.1186/ s12913-020-05692-7
24. Hammad EA, Alabbadi I, Taissir F, et al. Hospital unit costs in Jordan: insights from a country facing competing health demands and striving for universal health coverage. Health Economics Review. 2022;12(1). https://doi.org/10.1186/s13561-022-00356-0
25. Kutzin J. Health financing for universal coverage and health system performance: concepts and implications for policy. Bulletin of the World Health Organization. 2013;91(8):602-611. https://doi.org/10.2471/blt.12.113985
26. Sommers BD, Gawande AA, Baicker K. Health Insurance Coverage and Health — What the Recent Evidence Tells Us. New England Journal of Medicine. 2017;377(6):586-593. https://doi.org/10.1056/nejmsb1706645
27. Sommers BD, Maylone B, Blendon RJ, et al. Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults. Health Affairs. 2017;36(6):1119-1128. https://doi.org/10.1377/hlthaff.2017.0293
28. Mohammad O, Asaad B. Comprehensive Compulsory Health Insurance As A Strategic Option In Future Health Development Process (analytical study in Latakia governorate). TUJ-A. 2018;40(4). Available from: http://journal.tishreen.edu.sy/index.php/ humlitr/article/view/4772. Accessed December 10, 2022.
29. Abouelmaged E, Fasseeh AN, Elezbawy B, et al. PNS121 PRIVATE HEALTH INSURANCE COLLABORATION WITH PHARMACEUTICAL COMPANIES IN EGYPT. Value in Health. 2019;22:S782. https://doi.org/10.1016/j.jval.2019.09.2022
30. Basheti IA, Tadros OKI, Alnajjar MS, et al. Assessing patient satisfaction with the Medication Management Review service delivered in Jordan. Journal of Pharmaceutical Health Services Research. 2018;10(1):49-55. https://doi.org/10.1111/ jphs.12233
31. Asayut N, Sookaneknun P, Chaiyasong S, et al. Outcomes, costs and stakeholders’ perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review. International Journal of Pharmacy Practice. 2017;26(1):16-27. https://doi.org/10.1111/ijpp.12385
32. Etemad LR, Hay JW. Cost-Effectiveness Analysis of Pharmaceutical Care in a Medicare Drug Benefit Program. Value in Health. 2003;6(4):425-435. https://doi.org/10.1046/j.1524-4733.2003.64255.x
33. Dautzenberg L, Bretagne L, Koek HL, et al. Medication review interventions to reduce hospital readmissions in older people. Journal of the American Geriatrics Society. 2021;69(6):1646-1658. https://doi.org/10.1111/jgs.17041
34. Al-Hashar A, Al-Zakwani I, Eriksson T, et al. Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. International Journal of Clinical Pharmacy. 2018;40(5):1154-1164. https://doi. org/10.1007/s11096-018-0650-8
35. Hong SH, Liu J, Wang J, et al. Conjoint analysis of patient preferences on Medicare medication therapy management. Journal of the American Pharmacists Association. 2011;51(3):378-387. https://doi.org/10.1331/japha.2011.10039
36. Rickles NM, Skelton JB, Davis J, et al. Cognitive memory screening and referral program in community pharmacies in the United States. International Journal of Clinical Pharmacy. 2013;36(2):360-367. https://doi.org/10.1007/s11096-013-9904-7
37. Tsao NW, Khakban A, Gastonguay L,et al. Perceptions of British Columbia residents and their willingness to pay for medication management services provided by pharmacists. Canadian Pharmacists Journal: CPJ. 2015;148(5):263-273. https://doi. org/10.1177/1715163515597244
38. Sriram D, McManus A, Emmerton LM, et al. A model for assessment and referral of clients with bowel symptoms in community pharmacies. Current Medical Research and Opinion. 2016;32(4):661-667. doi:10.1185/03007995.2015.1135113.http://www. joif.org. Statistics of medical insurance and medical portfolios managed by insurance business management companies; 2020. Available from: http://www.joif.org/SystemFiles/Assets/The%20Initial%20Financial%20Indicators%20(Premiums%20&%20 Paid%20Claims).pdf. Accessed November 20, 2022