Jeffrey C. Keimer and Shaker A. Mousa
We evaluated the clinical and economic impact of generic drug discount programs (GDDPs), pharmacy based immunization services and convenient care clinics (CCCs) based upon existing literature, reviewing original research and case study reports using library databases, primarily MEDLINE and EBSCOHost. Keywords used included “generic discount list,” “four dollar generic,” “pharmacy immunization,” “flu shot,” “pharmacist immunizer,” “convenient care clinic,” “retail health clinic,” and “minute clinic.” We then added other terms such as “clinical impact,” “cost-effectiveness,” “outcomes,” and “perceptions.” While all 3 programs have the potential to clinically benefit patients and provide some level of cost-effectiveness, there are also concerns that need to be addressed. Some concerns include: a) GDDPs have the potential to cause fragmentation of care owing to patients going to other pharmacies in search of lower prices and prescription claims data not being captured by patients’ pharmacy benefit managers, b) GDDPs may be less cost effective in pharmacies with less purchasing power compared to larger chains, c) pharmacy based immunization services still face legal and social barriers that prevent pharmacists from being recognized as legitimate vaccine administrators, d) some insurance carriers still don’t pay for pharmacist-administered vaccinations, e) CCCs may not currently be located in areas that could best benefit from their services, f) CCCs may disrupt a patient’s continuity of care with their primary care physicians, and g) CCCs may hinder the efforts of pharmacists to expand their own professional roles by lessening the need for them to do so. Expanding the roles of community pharmacies has the potential to improve patient care by increasing patients' access to healthcare services. While strong evidence exists to support pharmacist-delivered immunizations, less is known regarding GDDPs and CCCs. More studies are required to assess the clinical and economic questions raised regarding these types of programs.
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