ASSESSMENT OF THE TRANSITION TO ONLINE PRESCRIPTION REIMBURSEMENTS AT A NYC MEDICAL STUDENT PRIMARY CARE FREE CLINIC

ABSTRACT

BACKGROUND: Since the start of the COVID-19 pandemic, the Weill Cornell Community Clinic (WCCC) rapidly adapted to a hybrid telehealth model to serve its uninsured patient population. Prior to the pandemic, the WCCC provided coupons and in-person cash reimbursement to defray patients' out-of-pocket medication expenses. In March 2020, the WCCC adopted a hybrid telehealth model and enabled online medicationreimbursement. This study describes how the shift from in-person to online pharmacy reimbursement impacted the reimbursement volume and cost of commonly prescribed medications for uninsured patients. METHODS: Only medication reimbursement records from January 2017 to December 2021 were considered. Reimbursement records included information on the date of reimbursement, medication name, quantity, and cost. The frequency of reimbursement for each medication was calculated and the medications were classified by drug class, disease indication, and treatment course (chronic vs acute) using descriptive statistics. The average cost of each medication was calculated and stratified by mode of reimbursement. RESULTS: Since January 2017, WCCC had 1622 independent reimbursements. Of those, statins (14.7% of total reimbursements) and biguanides (8.2%) remained the two most common drug classes reimbursed. Since transitioning to an online method of reimbursement, reimbursements for medications treating chronic conditions increased 3%. Reimbursements for medications for the following disease indications changed the most upon transition to online reimbursement diabetes (+4.4%), hyperlipidemia (+4.2%), pain (+4.0%), immune dysfunction (-4.3%), and hypertension/cardiovascular disease (-3.3%). Of the two most reimbursed medications, atorvastatin 40mg had an average cost of $14.72 (range $10.00 -$30.45) when reimbursed online (RO) and $30.57 ($15.00 -$69.99) when reimbursed in-person (RI);metformin 1000mg had an average cost of $15.08 ($5.00 -$32.99) RO and $20.62 ($6.99 -$32.99) RI. CONCLUSIONS: The online method resulted in a greater proportion of reimbursements for medications treating chronic conditions compared to the in-person method. Additionally, the average costs of our two most prescribed medications were lower when reimbursed online than in-person. Further analysis will be performed to understand the factors contributing to the observed trends in reimbursement at WCCC.