Out-of-plan pharmacy use: insights into patient behavior

The purpose of this study was to identify and describe patient rationales for filling prescriptions at an out-of-plan pharmacy (OOPP).

A cross-sectional survey conducted in February 2013 among a random sample of 1000 patients.

Adult Kaiser Permanente Colorado (KPCO) patients who had a prescription electronically issued to an OOPP in November 2012 were surveyed. The study questionnaire was developed using items obtained from the literature and prepared de novo, as needed. The questionnaire included items regarding whether the electronic prescription issued to an OOPP was filled; if filled, which OOPP was used; factors that may have influenced the use of an OOPP; and the patient's ability to afford medications. Responses to the survey were tabulated and reported as percentages.

The survey response rate was 38%. Respondents (N=382) had a mean age of 61 years, 35% were males, and anti-hypertensives were their most common OOPP prescription. Overall, 330 (86%) respondents reported that they had their prescription filled at an OOPP. The most commonly reported OOPPs utilized were supermarket pharmacies (42%). Factors that influenced the decision to use an OOPP included the prescription being less expensive (58%), the OOPP had a discount generic prescription program (57%), and the OOPP's location was convenient (44%). Thirty-nine percent of respondents reported that using an OOPP helped them afford their prescriptions.

Prescription cost and pharmacy convenience were identified as the most significant drivers of OOPP use. Future research should be conducted to assess the health-related consequences of OOPP use.