A Pilot Program to Teach Pharmacy Students Practical Skills to Navigate Drug Insurance Benefits

Area of Science:

• Pharmacy Education
• Health Outcomes Research
• Health Services Research

Background:

• Traditional pharmacy curricula lack practical training in drug insurance benefits.
• Navigating prescription drug coverage is crucial for reducing patient out-of-pocket costs.
• Hands-on experience is needed to effectively teach formulary and cost-sharing navigation.

Purpose of the Study:

• To pilot an innovative, skills-based activity for pharmacy students to learn insurance formulary navigation.
• To assess the impact of this activity on students' ability to interpret drug coverage details.
• To determine if the activity enhances students' confidence in assisting patients with medication access.

Main Methods:

• A 6-week experiential rotation was implemented for pharmacy students.
• Students updated a public website with formulary information from six major insurance plans.
• Training focused on identifying drug coverage tiers, step therapy, prior authorization, and cost-sharing for over 250 drugs.

Main Results:

• 100% of surveyed graduates found the training helpful for understanding drug coverage, step therapy, and prior authorization.
• 90% of graduates reported improved ability to look up formulary coverage and prior authorization requirements.
• 65% of graduates felt more confident in determining copayment requirements.

Conclusions:

• The skills-based pilot activity effectively taught pharmacy students to navigate insurance formularies.
• This practical training is essential for equipping future pharmacists to help patients access medications.
• The activity demonstrated a significant improvement in students' confidence and competence in managing drug benefits.