Study credits existing delivery infrastructure for lack of disruption
While the first two years of the COVID-19 pandemic disrupted many aspects of health care delivery, most patients could still get prescription medications for managing their chronic conditions, a new study shows.
Traditionally, doctors prescribed drugs only after in-person visits. But with such visits either curtailed or nonexistent in the first years of the pandemic, the study’s authors wanted to know if patients were still able to obtain needed medications.
To find out, the researchers examined the mean monthly prescription fill rates in 2019, 2020, and 2021 for about 18 million Medicare beneficiaries, including 1.98 million diagnosed with dementia. They focused on five groups of medications commonly prescribed for chronic disease: angiotensin receptor blockers (used for hypertension and heart failure), statins, oral diabetes medications, asthma and chronic obstructive pulmonary disease medications, and antidepressants.
The researchers had hypothesized that the disruption of in-person care brought on by the pandemic would lead to a decline in use of prescription drugs. Instead, the results showed only a 2.6% dropoff in 2021 compared with 2019. Moreover, the declines were about the same among Blacks, Hispanics, and people diagnosed with dementia—groups that traditionally have faced barriers to care—as among whites.
The authors offer several possible explanations for the relative stability of prescription drug receipts during the pandemic. Among these are performance metrics for Medicare Part D plans that hold them accountable for medication adherence among patients with chronic illnesses, and the fact that even before the pandemic pharmacies had been using home delivery and, along with health plans, providing patient education, medication reconciliation and adherence coaching by telephone for high-needs patients.
The authors note that an existing delivery infrastructure and lack of dependence on face-to-face visits enabled patients were what enabled patients to continue getting needed medications during the height of COVID-19. In future pandemics, they write, “a similarly robust infrastructure to maintain clinician care provision…may mimic our current system of prescription delivery by fully enabling telehealth and telephone care as part of routine care-delivery models, reducing dependence on in-person visits and fostering care channel flexibility.”
The study, “Receipt of Medications for Chronic Disease During the First 2 Years of the COVID-19 Pandemic Among Enrollees in Fee-for-Service Medicare” was published May 17 in JAMA Network Open.