Consumers' evaluation of value-added pharmacy services.

One proposal for community pharmacies to survive in an increasingly competitive market is to offer services that consumers want and need. This study examined the effects of such a value-added pharmacy services (VAPS) program implemented at 19 experimental pharmacies; another 16 pharmacies served as a control group. The study found that patrons of VAPS pharmacies received more pharmacy services and were more likely to report that the pharmacist talked to them about their medication than patrons of control pharmacies. This study demonstrates that a value-added services program can have an impact on pharmaceutical services.

Value of pharmacy services: perceptions of consumers, physicians, and third party prescription plan administrators.

A study of patients, physicians, and third party prescription plan administrators was conducted to identify those pharmacy services they believe are important and valuable and to determine whether third party plan administrators would reimburse pharmacists for such services. Patient and physician focus groups indicated that both wanted personalized services related to medications. Physicians believe that pharmacists are talking to patients about their medications, whereas patients want more drug information but report that pharmacists are not always providing such information. A mail survey of 41 third party prescription plan administrators indicated they believe that pharmacy services are important to consumers and that pharmacists are already providing most of the services identified. One-third of the third party administrators said their companies would consider implementing a structured pharmacist incentive plan to improve enrollee satisfaction. Those whose companies would not most often gave "increased cost" as the reason. No clear relationship was shown between number or type of services and the incentive value offered. Providing administrators with evidence that enhanced pharmacy services will increase overall program cost savings may lead to implementation of pharmacy incentives.

Proposed drug-drug cost effectiveness methodology.

The advent of prospective reimbursement in hospitals has forced hospital administrators, pharmacy directors, and pharmacy and therapeutic committees to carefully compare the cost and benefits of similar drugs. Accomplishing this task is difficult. This paper reviews the literature on drug-drug cost effectiveness procedures and outlines a methodology that might be used to contrast and compare two drugs with similar therapeutic outcomes. The data to conduct this analysis can be obtained from published articles on clinical studies and company sources and entered into a microcomputer electronic spreadsheet. The study discusses the implications and use of cost effectiveness analysis to evaluate drugs by hospital formulary committees.

A survey approach for finding cases of epilepsy.

Identify persons with epilepsy by first looking for prescriptions for particular antiseizure drugs. Follow these prescriptions from the pharmacies to the physicians who wrote them for patients. Ask the physicians whether the patients have epilepsy. Finally, contact the patients who do have epilepsy to elicit information about the impact of that condition on their lives. With these steps, it may be possible to carry out successfully a probability survey of epilepsy in the United States population. To learn more about this approach, a field test was funded by the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) of the Public Health Service. From 1978 through 1982, the work was planned, carried out, and evaluated by Research Triangle Institute, Research Triangle Park, NC. Epilepsy is a sensitive topic to ask about in a survey. Also, the condition is sufficiently rare to render ordinary survey approaches inefficient. Even if rarity were not an issue, there would be the problem of response error because a person with epilepsy does not, as a rule, have much clinical information on his or her condition. Better information lies with the physician who provides the care, but many physicians are busy with their practices. Furthermore, their record systems are usually not designed for easy retrieval of information, unless the names of patients are available. In the survey approach considered here, the names of patients are obtained through a random sampling of prescriptions for antiseizure drugs. The field test was divided into three phases with special activities reserved for each. The most important problem confronted was how to safeguard the confidentiality of relationships between pharmacist and patient and between physician and patient.Special guidelines on confidentiality were put into effect for the data collection. These guidelines,however, contributed to serious problems of nonresponse-especially for physicians. This article provides a brief account of the field test, including a rationale for the survey strategy of finding cases of epilepsy through prescriptions for antiseizuredrugs.

A survey of state board of pharmacy members and continuing education providers' views on continuing education.

Legally accountable to the public, state boards of pharmacy are continually confronted with the problem of maintaining the quality of pharmacy practice. One approach to accomplishing this task has been to implement mandatory continuing education requirements for relicensure. This study evaluated the perceived effectiveness and deficiencies of various states' continuing education regulations. A 40-question survey was mailed to 600 pharmacy board members and continuing education providers to determine their attitudes toward continuing education, support of mandatory continuing education, and their opinion of alternative methods for improving the quality of pharmacy practice. Responses from approximately one-half of those surveyed indicate board members and continuing education providers were positively disposed toward continuing education. However, there was room for improvement in most states' mandatory continuing education regulations. A relicensure examination was considered to be the best method to ensure competency, while mandatory continuing education was viewed as acceptable to pharmacists, and relatively easy to administer. The consequences of the study's findings for modifying state continuing education regulations is discussed.

Effects of promotion on pharmaceutical demand.

The research question addressed in this study was, "Do changes in promotional expenditure cause changes in the size of the market (primary demand) or market share (selective demand)?" Two types of promotion were evaluated; sales calls to physicians and medical journal advertising. The sales elasticities of each of these promotional techniques were estimated through the use of ARIMA modeling. The market expansive effects and the market share effects were measured for each of 7 drugs in two therapeutic categories, the benzodiazepines and diuretics. The results of the analysis showed that there was no correlation between changes in detailing or journal advertising expenditures and primary or selective demand. Thus, it was assumed that the primary and selective demand elasticities for pharmaceutical advertising may be equal to zero. Drug manufacturers should evaluate the effects of reductions in their promotional expenditures, changes in promotional content, as well as seek alternative methods of advertising which may have a higher sales elasticity and effectiveness.

Pharmacists' perceptions of consumer demand for patient-oriented pharmacy services.

This study examined pharmacists' perceptions of consumer demand for various patient-oriented pharmacy services. Data on pharmacists' perceptions were gathered by a mail questionnaire of pharmacist-managers in Raleigh, NC. Conjoint and regression analyses indicate that pharmacists perceive little demand either for voluntary provision of advisory services or for patient medication records, and that pharmacists' perceptions of the demand for patient medication records relate significantly to their provision of this service. Comparison of pharmacists' perceptions of demand with previously collected consumer data indicates that pharmacists underestimate the demand for patient medication records but not for voluntary provision of advisory services. These findings suggest that pharmacists' perception of consumer demand is as important as actual consumer demand in explaining why pharmacists do not provide patient-oriented pharmacy services more frequently.

Consumer demand for patient-oriented pharmacy services.

The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households, were analyzed using Kruskal's program for additive conjoint analysis. The results indicate substantial consumer demand for making advisory services available on request, moderate demand for provision of patient medication records, and little demand for voluntary provision of advisory services.

The relationship between patient variables and frequency of pharmacist counseling.

Over the past 20 years, much research has focused on evaluating pharmacists' performance as drug consultants to patients and on identifying factors that affect pharmacists' performance in this role. Little has been done, however, to assess the impact of patient characteristics, such as age, income, education, and drug expenditures, on pharmacists' performance as drug consultants. The purpose of this study was to examine this impact. Data were gathered via a mail survey of 300 households in Raleigh, NC. Multiple regression analysis was used to analyze the data. Results indicated that pharmacists generally are available to answer patients' drug-related questions, that pharmacists usually do not provide counseling to patients voluntarily, and that pharmacists are significantly more likely to counsel patients who have lower educational attainment and higher drug expenditures. These results appear to suggest that pharmacists have adopted the role of drug consultant to patients, but only to a limited extent.

Patient behavior patterns regarding prescription refills.

This study was conducted to examine the association between drug price, drug category, duration of coverage of the original prescription, units prescribed per day, and a patient's failure to obtain authorized refills of prescription medication. A two-stage sampling of pharmacies and prescriptions yielded a total sample of 1,058 prescriptions. The Drug Possession Ratio (DPR), defined as the ratio of number of days of medication dispensed to number of days of medication prescribed, was significantly related to drug price and drug category (p less than 0.05). The highest DPR was associated with the most expensive medication. Tranquilizers, antidepressants, and sedative hypnotics exhibited high DPR, while antihistamines and decongestants exhibited low DPR.