Community pharmacist knowledge and behavior in collecting drug copayments from Medicaid recipients

Community pharmacists' knowledge and behavior regarding the collection of copayments for prescription drugs from Medicaid recipients were studied. In fall 1998 a questionnaire was mailed to a random sample of 1465 community pharmacists (one pharmacist per drugstore) in Maryland, Pennsylvania, and West Virginia. The objectives were to determine the extent to which these pharmacists waived copayments for prescription drugs for Medicaid recipients, to document the pharmacists' knowledge of federal policies on Medicaid copayments, and to evaluate the factors associated with pharmacist copayment collection and knowledge of federal copayment policies. A total of 543 pharmacists (37%) responded. Most respondents indicated that they collected copayments for over 90% of drugs dispensed to Medicaid patients subject to copayment policies. Pharmacists most likely to waive Medicaid copayments practiced in drugstores with a high volume of Medicaid-related prescriptions and a large percentage of customers who were elderly Medicaid recipients. Pharmacists least likely to waive copayments believed that doing so would have a negative financial impact on the pharmacy. Nearly three fourths of the pharmacists exhibited fair or good knowledge of federal Medicaid copayment policies, but this varied widely by state. Many said that they would collect copayments in at least some situations even if this opposed federal policy. Pharmacists in Maryland, Pennsylvania and West Virginia had highly variable behavior patterns and knowledge with respect to the collection of drug copayments from Medicaid recipients.