(1097) Patient Perceptions of a Subscription-based Clinical Service and Prescriptions in a Community-based Pharmacy

Objectives: The objective of this project is to determine patient perceptions of a subscription-based payment model for clinical services and prescriptions within a community-based pharmacy setting. Many patients struggle to afford their prescriptions from month to month. In 2016, approximately 15 percent of Medicare patients reported cost-related medication nonadherence. This has downstream implications on the effective management of chronic diseases such as diabetes, hypertension, and heart failure. An alternative solution involves patient utilization of a subscription-based payment model. Within this subscription model, patients agree to an annual or monthly fee to receive their medications and other clinical services within a bundled package. Clinical services may include blood pressure checks, glucose checks, yearly influenza immunization, annual covid testing, and pharmacist consultations. Such subscriptions may incentivize patients and contribute to improved adherence. Independent community-based pharmacies have an opportunity to create a subscription-based payment system for patients to receive their medications at a reduced cost while also receiving clinical service opportunities from a pharmacist.

Methods: This cross-sectional, survey-based study will be conducted at two independent pharmacies with common ownership in rural North Carolina. Participants will be eligible to be included if they are 18 years of age or older and receive at least one prescription medication from one of the two study locations. Individuals will be excluded if they are less than 18 years of age or do not receive at least one prescription medication from one of the two study locations. A 15-item questionnaire will assess participant’s interest in a subscription-based payment model, ability to afford their current medication regimen, likelihood to enroll in a subscription-based model, and demographic information. The survey will be pilot tested among a sample of pharmacists for feedback on validity and question structure prior to data collection. An electronic version of the survey will be developed via the online platform, Qualtrics. The survey may be completed by having the participant use a personal electronic device to scan a QR code on a posted sign at the pharmacy. A printed version of the survey will be available to those without a personal electronic device. A pharmacy staff member (pharmacist, student pharmacist, or pharmacy technician) may verbally complete the survey with the patient via the telephone. Completion of the survey is voluntary and confidential. Participants will have the option to enter a separate drawing for one of ten $10 gift cards as an incentive for survey completion. Once the study timeframe is complete, survey results will be exported into a password-protected Microsoft Excel file for analysis. Descriptive statistics will be utilized to analyze responses.

Results: Institutional Review Board approval is anticipated in October 2023. The survey will be open for 90 days and distributed from November 2023 to January 2024. Data analysis will occur in February 2024.

Conclusions: The purpose of this project is to determine how willing patients are to switch to a different type of payment model for their prescriptions. The survey results may also show the reason behind why patients are hesitant about switching to a different form of payment and this can inform strategies to target these patients.