Pharmacists' Experiences, Perceptions, and Knowledge of Direct-to-Consumer Prescription Coupons

Despite widespread use of manufacturer-sponsored prescription drug coupons and pharmacy network discount cards (i.e., direct-to-consumer prescription coupons), little is known about community pharmacists' experiences, perceptions, and knowledge of coupon cards.

To identify community pharmacists' experiences, perceptions, and knowledge of prescription coupons.

An 11-item telephonic survey was conducted from August 2018 to March 2019. Eligible respondents included English-speaking pharmacists employed during the survey period in a community pharmacy physically located in Connecticut. Data were analyzed via descriptive statistics and one-way analysis of variance (ANOVA). One-way ANOVAs were conducted to test the relationship between the respondents' practice types, the average daily volume of coupons processed, and the average time needed to process each coupon. The responses were based on a 5-point Likert scale and dichotomized to enable interpretation of the results.

There were 240 surveys completed from an eligible pool of 691 community pharmacy sites (34.7% response rate). Respondents representing 60 different businesses located across 123 of the state's 282 major ZIP codes, representing 83.5% of the state's population. Respondents overwhelmingly held positive perceptions of the ability of prescription coupons to increase patients' medication access (91.7 %) and reduce out-of-pocket costs (93.3%). However, respondents also believed patients have trouble paying for prescriptions once coupons expire (70.8%). When questioned about privacy practices, 57.5% of respondents believed that it is illegal to "sell patients' information" (i.e., with no distinction made between protected health information and any other information), while another 25.8% declined to answer, citing they did not know. Only 20.8% (n = 50) of respondents knew that community pharmacies could see lowered reimbursement from accepting network drug discount cards, and 40.4% (n = 97) knew that pharmaceutical manufacturers can cover the difference in patients' copay costs. Approximately 10% of respondents believed (incorrectly) that discounts from pharmacy network discount cards were covered via patients' prescription insurance and/or the third-party discount card vendor companies (7.9% and 3.3%, respectively). Respondents believed patients received prescription coupons most often from the internet or mail (77.1%), their prescribers (62.9%), or from their own community pharmacies (33.3%). Finally, on average, respondents processed 14.6 (SD 19.8) coupons per day and required 4.8 (SD 4.3) minutes for each claim.

As far as we know, this is the first exploration of community pharmacists' experiences, perceptions, and knowledge of direct-to-consumer prescription coupons. Results show that, while community pharmacists overwhelmingly hold positive perceptions towards prescription coupons and drug discount cards, there is an opportunity to increase general understanding of the differences in business practices between manufacturer-sponsored prescription drug coupons and pharmacy network discount cards. Community pharmacies also spend a significant amount of time processing coupon claims.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare no relevant conflicts of interest or financial relationships. This study was presented as a poster at the 2019 American Society of Health Systems Pharmacists Midyear Clinical Meeting during December 8-12, 2019, in Las Vegas, NV.