January 2015, Vol 3, No 1 - The First Word
Donald J. Dietz, RPh, MS

I was surprised to read that according to recent data from the US Department of Labor, the average hourly wage per worker in the United States is less than $20 per hour, with approximately 50% of Americans earning less.1

As healthcare professionals, we are fortunate to have chosen a profession with pay rates in the top 5% of the hourly wage chart. We have been blessed with the ability to complete our education as a pharmacist, physician’s assistant, or nurse practitioner, be employed, and earn salaries at the top end of the wage scale.

Value-Based Care
Based on our practice setting and location, many of us have clientele who mirror the US Department of Labor statistics or are below these wages. As we start the new calendar year, many patients have new insurance coverage, changes to their existing insurance coverage, or an annual deductible that is reset in January. For the 50% of wage earners who make under $20 per hour, this can impact their healthcare choices and treatment options in a variety of ways, leading to the following questions:

  • Is it worth it to seek medical help for an ailment knowing how much it will cost?
  • Should I get this brand prescription filled, or can I go without it?
  • Is there a generic or lower cost alternative for this medication?
  • I am in the deductible phase of my insurance coverage, how much will this cost?
All too often we first think clinically about the best treatment option for a particular patient. We need to be aware of signs that the product or service cost may be an issue for patients, especially early in the calendar year because of deductibles and the burden of paying off holiday bills.

Overcoming Barriers to Care and Compliance
What can we do as healthcare professionals? If a patient needs an expensive brand prescription product, consider manufacturer-offered financial assistance programs, or copay cards that may reduce their out-of-pocket costs. If a generic medication is prescribed, does your pharmacy offer a discount program that could help your patient save money on the prescription? If an over-the-counter (OTC) product is needed, it is important for healthcare professionals to understand patient symptoms, comorbidities, allergies, and other medications currently being used. Suggest the best OTC product available, and if it is available in a private label version at a lower price point, consider offering that option to your patient. It is a good idea to offer choices to patients so that they are aware of different options at various price points.

It is also important to validate that the patient is adherent with their currently prescribed products. Medication cost is one of the many reasons patients are noncompliant. If the patient is asymptomatic, such as a patient with hypertension or elevated cholesterol, it is especially important to educate them on the benefits of remaining compliant with their prescribed medications. In many situations, medication adherence is the lowest cost option for treating a chronic illness.

The take away message is that it is important to keep in mind your patients’ needs, both clinically and financially. Where possible, seek to identify treatment options they can afford. In the early months of 2015, consider focusing more on this concern, as more patients are in the deductible phase of their insurance coverage.




Reference
  1. US Department of Labor. Wage and hour division (WHD): minimum wage laws in the states–January 1, 2015. www.dol.gov/whd/minwage/america.htm. Updated December 2014. Accessed January 5, 2015.
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