Medications are the most cost-effective treatment for medical conditions, and yet patients routinely miss doses, fail to refill a prescription or stop taking medications without consulting their provider. Nationally, half of the 3.2 billion annual prescriptions dispensed are not taken as prescribed, which translates to $105 billion in avoidable healthcare costs each year. Medication synchronization (med sync) is increasingly being recognized as a tool that can improve adherence when patients are on a regular chronic medication regimen. In Kentucky, there were still barriers in place for patients and pharmacies when trying to synchronize the prescriptions to the same refill date every month. Not all payers had policies in place to allow a synchronization of medications to occur. For example, a “short fill” or partial fill of a prescription is often needed to align the patient’s medications to a single refill date. Prior to SB 44, many payers would not approve a pro-rated co-pay (a co-pay based upon the actual amount of medication received) which served as a financial barrier for patients. Legislation was necessary to remove barriers to access and ensure patients, healthcare providers and pharmacists could utilize this tool to improve adherence to medications and the overall health of Kentuckians.
Working with Senator Julie Raque Adams, Chair of the Senate Health and Welfare Committee, we quickly moved to engage third-party advocacy groups to support the legislation – including the KY Pharmacists Association, American Cancer Society, Epilepsy Foundation of Kentuckiana and the National Community Pharmacists Association. These groups engaged legislators from a grassroots level communicating through letter writing campaigns, social media and personal testimony.
Opposition came in the form of insurance companies, pharmaceutical benefit managers (PBMs) and the KY Department of Insurance who routinely stated legislation was not necessary and that med sync would result in health insurance premium increases. Data proved otherwise and through the combination of our grassroots and direct lobbying efforts we were able to cut through the misinformation from our opposition to ensure legislators had correct information prior to casting a vote.
SB 44 was signed by the Governor on March 20, 2015 and will take effect January 1, 2016. The bill passed both chambers without one dissenting vote: Senate 34-0 and the House of Representatives 97-0. By passing this legislation, we have eliminated barriers to care and given Kentuckians access to a tool that will increase medication adherence, promote positive health outcomes and lower overall healthcare costs.