Academic journal article American Journal of Pharmaceutical Education

Impact of an Elective Course on Pharmacy Students' Attitudes, Beliefs, and Competency regarding Medicare Part D

Academic journal article American Journal of Pharmaceutical Education

Impact of an Elective Course on Pharmacy Students' Attitudes, Beliefs, and Competency regarding Medicare Part D

Article excerpt


The passage of the Medicare Modernization Act (MMA) in 2003, followed by the implementation of the Medicare Part D benefit in 2006, greatly increased prescription drug access for many of the nearly 47 million Medicare beneficiaries. (1,2) However, with increased use of prescription medications comes the increased risk of medication-related issues. The MMA partly addressed this issue by requiring each Part D plan to provide medication-therapy management (MTM) services.

Since the inception of the benefit and despite concerted efforts by the Centers for Medicare & Medicaid Services, beneficiaries have demonstrated significant difficulty understanding the intricacies of Part D. (3) Early on, healthcare providers complained that the program was too complex and difficult for the targeted population to understand, and this was confirmed by research. (4,5) Beneficiaries complained of having too many Part D plans from which to choose and expressed fear that if they changed plans, they might not make the optimal choice. (6) This fear caused many to simply "make do" with their current plan. (7)

Studies focusing on the experiences of beneficiaries dealing with the Part D benefit have shown that although most were satisfied, many were unwilling to change plans for fear of undertaking the complex procedure. (8) In a 2008 national telephone survey, 574 (80%) of the 718 respondents age 65 years and older found Part D to be too complicated, and 539 (75%) wanted a reduction or simplification in the number of Part D plans offered. (9)

Not only have beneficiaries reported being overwhelmed, (10) but counselors assisting beneficiaries with plan enrollment have also remarked on the difficulties. (11) Many Medicare beneficiaries have limited financial resources and are not confident in making decisions on matters with which they are unfamiliar. (10) Beneficiaries' lack of knowledge and understanding of Part D may contribute to selection of suboptimal plans and result in higher out-of-pocket costs. (12,13)

Medicare's online Plan Finder Tool may optimize beneficiaries prescription drug benefit by generating the estimated annual cost based on beneficiary-specific information. However, only 26% of people over 65 years of age use the Internet. (14) Moreover, the Plan Finder Tool has proven difficult to navigate, even for the most Internet-savvy seniors. (15) Accordingly, such an elaborate process calls for beneficiary advocacy, which presents a unique opportunity for pharmacists and pharmacy students.

As challenging as navigating the Part D benefit may be for beneficiaries, pharmacists have also found it difficult. In 1 study, 17 faculty members from 6 different colleges and schools of pharmacy received training on the Part D benefit. Their Part D knowledge and confidence in using the Plan Finder Tool were evaluated before and after the training program. Prior to receiving training, only 47% of faculty members were able to correctly use the Plan Finder Tool to compare prescription drug plans. This percentage increased to 100% post-training. (16)

The Accreditation Council for Pharmacy Education (ACPE) guidelines reflect the increasing importance of training pharmacy students to provide patient-centered care. For example, a specific objective of the ACPE guidelines is for students to work interprofessionally to promote health and wellness in communities. Medicare Part D has created unique opportunities in pharmacy education, such as MTM training, that will require students to master these professional competencies.

A study at University of California, San Francisco, found that training resulted in a significant improvement in second-year pharmacy students' ability to correctly determine the name and associated cost of the least expensive Part D plans (47% vs 74% before and after training, respectively). (18) Another study found that pharmacy students who learned about Part D in the classroom setting better understood the complexities of the benefit and empathized with beneficiaries regarding the challenges it poses. …

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