Patients' willingness to pay for pharmaceutical care

Consumers' Willingness to Pay for Pharmacist Counselling Services and the Factors Affecting It in Community Pharmacies

Background

Community pharmacists play an important role in improving outcome by providing advice and counselling services to patients.

Objectives

The aim of this study was to measure the willingness to pay (WTP) for pharmacist counselling services in community pharmacies and identify determinant factors on consumers' WTP.

Methods

A self-administered questionnaire-based survey was conducted in community pharmacies in Tehran (capital of Iran) from January 1, 2020 to February 20, 2021. Contingent valuation method was applied to evaluate respondents' maximum WTP using three hypothetical scenarios illustrating different levels of counselling services. Logistic regression was used to analyze the association between different variables and WTP for pharmacy services.

Results

Total number of participants who completed the questionnaire were 332 and 60% of the participants were male. In the first scenario 70.2% of participants were willing to pay for oral counselling pharmacy services. In the second and third scenario, percentage of people willing to pay increased to 79.5%. and 86.1%, respectively. In the first scenario, monthly income (OR = 0.041, P value = 0.04), the duration of underlying illness (OR = 0.04, P value = 0.04) and the using internet (OR = 2.59, P value = 2.59) had a statistically significant relationship with willingness to pay. In the third scenario, the willingness to pay increased as the age decreased. The possibility of using the internet (OR = 3.32, P value = 0.00) and the need for a community pharmacist (OR = 2.19, P value = 0.03) increased the chance of willingness to pay.

Conclusions

More consumers are willing to pay for more pharmacist counselling services. Therefore, improving the quality of counselling services could have positive economic effects on community pharmacies.

Influence of patient-pharmacist relationship on willingness to accept pharmacist-provided services

BACKGROUND

Willingness to accept various pharmacist-provided services such as health promotion and medication management is still considered low. Evidence suggests that patient experience and socio-demographics partially explain patient willingness to use pharmacy services. However, the influence of a patient's relationship with their pharmacist may provide additional explanatory power.

OBJECTIVES

The aims of the study were to [1] explore the willingness to accept pharmacy services across patients' relationship with pharmacists and [2] evaluate the association between the patient-pharmacist relationship and patients' willingness to accept pharmacist-provided services.

METHODS

A total of 1521 respondents' data on the types of patient-pharmacist relationships and willingness to accept dispensing, drug information, medication management, and health promotional services were collected from the 2021 National Consumer Survey on Medication Experience and Pharmacists' Role. Willingness scores across the groups were evaluated using chi-square and analysis of variance. Binary logistic regression was used to investigate the associations between patient-pharmacist relationships and willingness to accept pharmacist-provided services.

RESULTS

More respondents were "definitely willing" to accept dispensing services (68.5%) and drug information (68.3%), while 56.5% and 50.1% were "definitely willing" to accept health promotion and medication management services, respectively. While respondents with "customer" and "client" archetype relationships were definitely willing to accept the 4 categories of pharmacy services, the highest proportion of respondents definitely willing to accept the services was observed among those with "partner" archetype relationships. Willingness scores increased significantly across the archetype relationships. Respondents with a "partner" archetype relationship had the highest and most significant odds ratio of accepting all the categories of pharmacist-provided services.

CONCLUSION

Willingness to accept services from pharmacists increased as the level of the patient-pharmacist relationship grew. Patients in "partner" archetype relationship were significantly more likely to accept all categories of pharmacist-provided services. Pharmacists are encouraged to embrace the patient-pharmacist relationship continuum to optimize patient care.

A pilot study to assess the need for new hospital pharmaceutical services in Algerian patients and physicians’ perspective

Objectives

The objective of this study was to assess the needs for pharmaceutical services from the perspectives of physicians and patients in the hospital setting and to contribute to the implementation of new hospital pharmacy activities.

Methods

A cross-sectional descriptive study was carried out among the doctors and patients encountered in hospital departments in Sidi Bel Abbès (Algeria); each service was evaluated using a Likert scale. Associated characteristics with an important need were evaluated by univariate analysis and binary logistic regression.

Key findings

All pharmaceutical services were important to the patients, particularly providing treatment advice and therapeutic education. Women presented an important need for insurance of the availability of pharmaceutical products (P = 0.02) and lifestyle and dietetic information (P = 0.05). High frequency of taking medication was associated with an important need for information about drug interactions (P = 0.005). Patient-oriented pharmaceutical services were not important to the physicians who considered drug information and therapeutic education to be the most important need.

Conclusions

To implement patient-centred services, it is important to improve the contact between pharmacists and physicians and to provide information about pharmaceutical services that can benefit patients. Implementation of new practices in university hospital is more feasible than in public health facilities.

Community pharmacists' perspectives about the sustainability of professional pharmacy services: A qualitative study

OBJECTIVE

Pharmacists have been increasing patient-focused care through the implementation and provision of professional services. However, there is a lack of evidence on how to achieve long-term sustainability of the service once it is implemented. A framework identifying the factors affecting the sustainability of professional pharmacy services was developed. The objectives of this study were to explore the experiences of community pharmacists providing professional services to contextualize and assess the applicability in practice of the sustainability framework.

METHODS

A qualitative study was undertaken across Australia. Community pharmacists were identified using snowball sampling. Data were collected through semistructured interviews. Eighteen interviews were conducted and analyzed using framework methodology in NVivo 12 (QSR International).

RESULTS

A range of major sustainability factors was identified and organized in social, economic, and environmental domains. In the social domain, most of the interviewees stated the importance of motivating staff to increase service promotion and patients' demand. Most of the participants emphasized that having an adequate number of trained staff is required to enhance and maintain services over time. The perceived reluctance of some patients to spend more time than usual at the community pharmacy was another factor highlighted as affecting service sustainability. In the economic domain, the concern about lack of remuneration for service provision was highlighted by most of the interviewees. Having economic support was seen as essential for achieving sustainable services. In the environmental domain, the necessity of government recognition of the pharmacists' role and value to the health care system was identified as a new key sustainability driver.

CONCLUSION

The applicability of the framework for the sustainability of professional services was evaluated in practice. The identified factors will guide pharmacists to maintain implemented services and achieve their sustainability. Future research should focus on designing a tool to measure the sustainability of pharmacy services.

Patient Satisfaction and Their Willingness to Pay for a Pharmacist Counseling Session in Hospital and Community Pharmacies in Saudi Healthcare Settings

Objective

Patient satisfaction is an indicator for quality of healthcare service and is sometimes linked to patients’ willingness to pay. Willingness to pay is an economic method for estimating patient’s inclination for a service in monetary terms. This study assessed satisfaction of patients from pharmacist counseling service and estimated their willing to pay for the same.

Methods

A month-long survey was conducted in community and hospital pharmacies located in Khobar, Dammam, and Qatif cities of Saudi Arabia, using Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction with counseling as well as willingness-to-pay. Convenient sampling method was used, and sample size was calculated based on power analysis. Data was analyzed through SPSS version 23. Chi-square (χ²) test and logistic regression analyses were conducted to report associations between variables and, determinants of satisfaction as well as willingness to pay respectively. The study was approved by concerned ethical committee (IRB-2019-05-020).

Results

Patients (n = 531) with previous counseling experience were more likely to be satisfied [adjusted odds ratio (AOR) 5.2, p < 0.05]. Patients were more willing to pay if, they had an income above SAR 10,000 i.e., USD 2666.5 (AOR 1.78, p < 0.05), were satisfied with counseling time duration (AOR 4.5) and, were able to get counseling without difficulty (AOR 2.1, p < 0.05). Patients were more likely to be satisfied and were willing to pay if, they received required knowledge/information completely (AOR 2.5, 3.7, and p < 0.05) and found pharmacist helpful (AOR 1, 4.5, and p < 0.05). Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10.

Conclusion

Patients considered counseling as an important service and were satisfied from it. Less than a third of patients were willing to pay for the service. Knowledge and helpfulness of pharmacist were identified as two major determinants that could not only satisfy and but also promote willingness to pay for the service. A pharmacist with skills in pharmaceutical care and counseling could be useful in promoting the service and making it profitable for pharmacy business.

Satisfaction and expressed needs of pharmaceutical care services and challenges recognized by patients in South Korea

PURPOSE

To assess the degree of satisfaction and expressed needs of pharmaceutical care services in patients with chronic diseases and explore the factors related to the needs from patients' perspectives for the further development of pharmaceutical care service models.

PATIENTS AND METHODS

A cross-sectional survey of 220 patients (mean age ± SD: 61.3±13.1, male:female: 104:116) was conducted. The questionnaire was structured to measure patients' degree of satisfaction and expressed needs using a 5-point Likert scale. Additionally, preferred duration, methods of service delivery, and willingness to pay were surveyed. Responses were analyzed using an ordinal regression method to predict factors that were related to pharmaceutical care services.

RESULTS

Sixty-seven patients had experienced pharmaceutical care services. Their satisfaction levels were high in all categories; however, there were no significant differences between categories. The levels of expressed needs were similar among categories without significant differences. The preferred delivery method was a face-to-face conversation combined with being provided with written information (53.2%). The preferred duration was ≤10 min (70.5%). About 48% of the patients showed willingness to pay for the service. Education level and region influenced patients' needs.

CONCLUSION

The satisfaction and needs of pharmaceutical care services was very positive; however, noticing only a third of patients experienced pharmaceutical care services, this may indicate a lack of awareness and less appreciation of pharmacists by patients. Details concerning patients' awareness and the value of pharmaceutical care services require further investigation.

Patients' perceptions of a pharmacist-managed weight management clinic in a community setting

BACKGROUND

There have been many studies demonstrating patients' willingness to pay for medication therapy management services provided by pharmacists. There are few studies, however, evaluating the possible provision of a weight management service in the community pharmacy setting.

OBJECTIVES

The objectives were to (1) determine patients' knowledge of obesity and its resultant health risks, (2) determine patients' beliefs about obesity, (3) determine interest in pharmacist-delivered weight management services, and (4) identify factors associated with knowledge, beliefs, and interest in obesity and/or weight management services.

METHODS

One thousand patients were selected from 5 community pharmacies under a single chain located within a large metropolitan area to receive a mail survey. Survey items assessed patients' knowledge of obesity and the health risks associated with it by using the Obesity Risks Knowledge Scale and the Obesity Beliefs Scale. Additional survey questions were added to measure patients' willingness to pay for a pharmacist-managed weight management clinic. Descriptive statistics and linear regression models were used in analysis of the data.

RESULTS

Nearly two-thirds (62%) of respondents were classified as overweight or obese based on self-reported height and weight. Most of the respondents demonstrated an average level knowledge regarding the health risks associated with obesity. Attitudes toward obesity were commensurate with prevailing knowledge. Only a small proportion (13%) of respondents were willing to pay out of pocket for a pharmacist-delivered weight management service. Very little variance in knowledge, beliefs, or interest in pharmacist-delivered weight management services were identified.

CONCLUSIONS

Despite the fact that patients are aware of the health risks associated with obesity and believe it is healthier to maintain ideal body weight, most are not doing so. Additionally, most patients are not willing to pay for pharmacist-delivered weight management services. The findings can begin to assist pharmacists in developing strategies for implementation of weight management services.

Willingness to pay for a pharmacist's dispensing service: a cross-sectional pilot study in the state of Penang, Malaysia

Objective

The aim of this pilot study was to assess the value of the dispensing service of pharmacists from the general public’s perspective using the contingent valuation technique in the State of Penang, Malaysia.

Methods

Participants were conveniently sampled from malls and were given a self-completed questionnaire that collected the patient’s demographic information and their knowledge about the pharmacist’s dispensing service. They were then presented with a description of the pharmacist’s dispensing service, the risk of medication errors in prescriptions and their consequences, and the risk reduction of medication errors associated with pharmacist intervention. The willingness to pay (WTP) of the participants was later assessed using a contingent valuation interview that asked the likelihood and maximum amount they were willing to pay.

Results

In the study, 100 people participated, and 57% were aged between 18 and 35 years. Of these participants, 51% were women, and 46% of them earned more than 1000 MYR (285.71USD) per month. In addition, 8% of the participants had never visited a community pharmacy. Finally, 67% of the participants were willing to pay for the pharmacists’ dispensing service, and the median amount that the participants were willing to pay was 10 MYR (2.86USD). The WTP amount was moderately correlated with their knowledge of the community pharmacist’s dispensing services (r=0.377, p=0.02).

Conclusion

Generally, the public valued the pharmacist’s dispensing service. Their acceptance can be further improved by educating the public on the role of the pharmacist.

Assessment of attitudes of University of Nigeria pharmacy students toward pharmaceutical care

Objective:

The purpose of this study was to describe the attitude of University of Nigeria pharmacy students towards pharmaceutical care. Method: A survey of pharmacy students in their second to fifth year was conducted. A modified 13-item standard Pharmaceutical Care Attitudes Survey (PCAS) was used for the study. Reliability and factorial validity of the modified instrument were assessed.

Results:

Modification of the instrument did not alter its validity. Students of the University of Nigeria had a positive attitude towards pharmaceutical care as attitude score of all the items were above the midpoint score of 2.5. The mean scale score of second and third year students were significantly lower than that of the fifth year’s (Oneway ANOVA, p<0.001). Females had a higher positive attitude score compared to male students (Students t-test, p=0.005). There was no significant difference in the mean scale score among those that had work experience and those without work experience. Marital status did not influence attitude score.

Conclusion:

University of Nigeria pharmacy students had a positive attitude towards pharmaceutical care. However, it is necessary to provide sites were students could acquire practice experience and these sites should be designed to enable students observe the integration of pharmaceutical care activities into pharmacy practice.

Pharmaceutical Care: What's in a Name? A Qualitative Analysis of Patient Perceptions of Pharmacy Practice

Background:

Pharmaceutical care has been integrated into the mission statement of every major pharmacy school and the profession of pharmacy in the US.

Objective:

To evaluate patients' awareness and understanding of pharmacy practice, pharmacy services, and pharmaceutical care.

Methods:

A cross-sectional study was conducted involving completion of a self-administered questionnaire by participants frequenting community pharmacies (independent, chain, discount, and grocery) in Georgia. Content analyses were performed to assess participants' knowledge and perception of available pharmacy services and pharmaceutical care.

Results:

Approximately half of the study participants were unfamiliar with pharmaceutical care despite its integration into pharmacy education. One percent described pharmaceutical care as the compounding phase of pharmacy, 2% described it as the early clinical practice model, 45.3% equated pharmaceutical care with dispensing (ie, the “professional shopkeeper”), and approximately 52% described pharmaceutical care accurately. Forty-three percent described at least one of the subcomponents of basic pharmaceutical care (ie, pharmacist commitment, definite outcomes, or process of care [eg, counseling, drug utilization review]) and 8% described true or enhanced pharmaceutical care (ie, quality of life).

Conclusions:

The practice of pharmaceutical care is not widely understood by patients. Furthermore, many patients were unaware of the cognitive and clinical services that pharmacists provide. In the future, we expect the pharmacy profession to educate not only its pharmacists, but also its patients, about pharmaceutical care. Patients may not be seeking or demanding available services from their pharmacists because they are uninformed.

Using the Health Belief Model to test factors affecting patient retention in diabetes-related pharmaceutical care services

BACKGROUND

Diabetes is one of the deadliest and most costly diseases. Attrition rates among patients in diabetes management programs may preclude optimal success. Theoretical models, such as the Health Belief Model, may be useful for identifying factors responsible for patients' continued enrollment in such programs.

OBJECTIVES

(1) To design and test a reliable and valid survey instrument for assessing patients' perceptions of diabetes-related pharmaceutical care services. (2) To determine factors affecting patient retention in pharmaceutical care services.

METHODS

This cross-sectional exploratory study used convenience sampling to survey type 1 and 2 diabetes patients receiving pharmaceutical care at 25 Eckerd Pharmacy sites in Florida. Survey items were designed using constructs from the Health Belief Model. Reliability (Cronbach's alpha) and validity (exploratory factor analysis) were assessed. Independent t tests, Pearson's correlation coefficients, and multiple regression analysis were conducted.

RESULTS

Seventy usable surveys were returned (47%). In the absence of pharmaceutical care, patients felt susceptible to at least one of 8 diabetes-related conditions (hypoglycemia, hyperglycemia, diabetic foot infections, eye problems, cardiovascular risks, blood pressure problems, cholesterol problems, and kidney diseases). For these conditions, about 48% to 95% of patients perceived that their threat had reduced because of pharmaceutical care. Accordingly, more than half perceived the services as beneficial, with counseling for blood sugar monitoring rated as the most beneficial. All respondents rated the services as helpful, and 64 intended to continue regular utilization. Overall helpfulness of the service and patient retention were positively correlated (r=0.33, P<.00). Perceived susceptibility predicted perceived threat reduction (R(2)=0.22, P<.01). Perceived threat reduction, blood sugar monitoring, and overall helpfulness of the service predicted patient retention in the service (R(2)=0.41, P<.00). Factor analysis extracted 4 factors: perceived threat reduction, perceived susceptibility, perceived benefits, and blood sugar monitoring. Cronbach's alphas for the scales ranged from 0.63 to 0.91.

CONCLUSION

Two key constructs of the Health Belief Model influence use of diabetes-related pharmaceutical care services: perceived susceptibility and threat reduction. In an effort to increase patient retention, pharmacists need to assess patient perceptions and structure their services to address patient perceptions and concerns.

Patients' willingness to pay for pharmacist-provided menopause and hormone replacement therapy consultations

OBJECTIVE

To determine what women would be willing to pay for pharmacist-provided menopause and hormone replacement therapy consultations and the relationship between willingness to pay (WTP) and patients' perceptions of importance of resolving menopausal symptoms, their satisfaction with physician services, their perceptions of pharmacists' abilities, and income.

METHODOLOGY

A convenience sample of 203 adult women using medications to treat menopause was recruited by their pharmacists. A self-administered survey was used to address the study objectives. The contingent valuation method was used to assess WTP in 4 scenarios (ie, 50% and 100% improvement in symptoms after a half-hour initial and a half-hour follow-up visit, respectively). Logistic regression analyses were used to assess the relationship between WTP and the independent variables.

RESULTS

Two hundred and three surveys were returned resulting in a response rate of 41%. Across all 4 scenarios, at least 85% of women surveyed were willing to pay a minimum of 20 US dollars for pharmacist-provided menopause and hormone replacement therapy services. Respondents were willing to pay a median of 40 US dollars (for both 50% and 100% improvement) per half-hour for initial consultations, and 20 US dollars and 40 US dollars (50% and 100% improvement, respectively) per half-hour for follow-up consultations. Regression analyses revealed that across all 4 scenarios, patients' perceptions of pharmacists' abilities and income were significantly and positively (P < .05) related to WTP for menopause and hormone replacement therapy counseling.

CONCLUSION

This study showed that most women surveyed were willing to pay for pharmacist-provided hormone replacement therapy and menopause counseling services and that the WTP amounts increased as patients' perceptions of pharmacists' abilities and income increased. If pharmacists can effectively educate the public about their capabilities and expertise, they may discover that they have a new niche opportunity.

Improving medication use through pharmacists' access to patient-specific health care information

OBJECTIVE

To review and discuss the importance of pharmacists having access to patient-specific health care information in order to provide pharmaceutical care.

DATA SOURCES

Articles identified through searches of MEDLINE and International Pharmaceutical Abstracts using the following key words: information, decision making, and pharmacist.

STUDY SELECTION

English-language articles were evaluated for inclusion.

DATA SYNTHESIS

Pharmacists have demonstrated their ability to positively affect patient outcomes related to medication use, including reducing patients' risk for medication-related adverse effects.

CONCLUSION

Pharmacists, with proper access to patient-specific health care information, can reduce patients' risk for medication-related problems and improve the quality of their health care.

Consumers' willingness to pay for pharmacy services that reduce risk of medication-related problems

OBJECTIVE

To measure willingness to pay (WTP) for pharmacists' services directed toward reducing the risk of medication-related problems and to determine factors that have a significant influence on WTP.

DESIGN

WTP was measured using a contingent valuation method that involved asking respondents about their maximum WTP for pharmacists' services using a self-administered questionnaire. Respondents' WTP through ex post (out of pocket) and ex ante (insurance premium) methods were measured using three hypothetical scenarios illustrating reductions in the risk of medication-related problems. Logistic regression and semilog regression were performed to evaluate the responses to the survey.

SETTING

Outpatient clinic of Robert Wood Johnson University Hospital and two physician offices located in New Jersey.

PARTICIPANTS

A convenience sample of 316 patients and/or family members, who visited the study site between March 1 and September 15, 1999, were included.

MAIN OUTCOME MEASURES

Amounts patients were willing to pay out of pocket or through insurance premiums for pharmacists' services.

RESULTS

The mean WTP out of pocket for pharmacy services ranged from $4.02 to $5.48 per prescription, depending on the level of risk reduction. Mean WTP through an increased insurance premium ranged from $28.79 to $36.29 per year. Overall, the average WTP for a pharmacist's consultation was $5.57, and WTP increased by $0.87 as counseling time increased by 1 minute. WTP was sensitive to changes in the magnitude of risk reduction in both ex post and ex ante scenarios. Income was positively related to WTP, but not to the level of statistical significance.

CONCLUSION

Respondents were willing to pay for pharmacists' services that reduce the risk of medication-related problems. Additional investigations to determine the factors that influence WTP for health care professionals' services are warranted.