By Michelle Andrews August
4, 2017
For
people who take multiple medications to manage chronic conditions, traipsing
back and forth from the pharmacy to pick up pills can make it harder
to stick to their doctors’ orders. But because insurers often don’t allow
consumers to fill partial prescriptions to make medication renewal dates
align, patients sometimes have no choice but to frequently shuttle to the drug
store for refills.
Starting
next year, that will change in Florida when the state’s new medication
synchronization law goes into effect. The law, passed this
year, requires insurers to let enrollees align the refill dates for most drugs
at in-network pharmacies at least once during their insurance plan year. The
insurers must pro-rate patient co-payments for partial refills.
The
law doesn’t apply to self-funded companies that pay their workers’ medical
claims directly.
Generally,
prescriptions for chronic conditions are renewed every 30 days. Insurers often
balk at covering a refill of a drug sooner than that, leaving patients to make
a full copayment even if their doctor writes a prescription for a partial
order.
The
Medicare program allows beneficiaries with Part D drug plans to request less than a full month’s supply of a drug
and pay a pro-rated amount.
Consumer
advocates say medication synchronization isn’t
as serious a problem as not having coverage for the specific drugs or not being
able to afford them because of high cost sharing. Still, the hassle factor of
making multiple monthly trips to the pharmacy to get their drugs increases the
odds that people will miss important medications.
The
new law will make a big difference for HIV patients, many of whom take at least
five HIV drugs and may need medications for other conditions such as high
blood pressure or diabetes, said Michael Ruppal, executive director at the
Tampa-based AIDS Institute, which advocated for the bill. He cited as an
example one HIV patient who was on 11 medications, some of which he received
through the mail and others that he picked up at two different retail
pharmacies.
“People
make all these multiple stops on different dates,” Ruppal said. “He had to
track it all on a calendar.”
Florida,
despite being a magnet for retirees, many of whom have chronic conditions, is
hardly one of the first states to address this issue. Since 2014, about two
dozen states have passed laws or put regulations in place requiring medication
synchronization, said Fara Klein, manager of state government affairs at the
National Community Pharmacists Association.
In
addition to making it easier for patients to stick to their drug regimens, the
new law may encourage patients to have conversations with
their pharmacists at least once a year. When they align the drug renewals,
they can also ask questions about how to take a drug, side effects and
drug interactions, say advocates.
“For
people who are over 50, it’s so important that pharmacists will be looking out
to make sure there are no bad drug interactions,” said Dorene Barker, associate
state director for AARP Florida.
Please
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ideas for future topics for the Insuring Your Health column.
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