OBJECTIVES: Medication synchronization (med-sync) aligns patients’ chronic medications to a predetermined routine pickup date at a community pharmacy. An appointment-based model (ABM) med-sync service includes a comprehensive medication review or other clinical appointment at the pharmacy. We compared the cost and healthcare utilization outcomes of Medicare beneficiaries enrolled in an ABM med-sync program to beneficiaries not enrolled in such a program.

METHODS: This retrospective cohort study included Medicare beneficiaries obtaining medications from pharmacies providing ABM med-sync. Medicare inpatient, outpatient, emergency, and pharmacy claims data from 2014 to 2016 were used to create med-sync (n=13,193) and non-med-sync (n=156,987) cohorts. All patients were followed longitudinally for 12 months before and after a 2015 index/enrollment date. Baseline characteristics including age, gender, race, geographical region, income-based enrollment status, copayment, and urban residence were utilized to create a logistic regression model for propensity score matching. A 1:1 greedy nearest neighbor matching algorithm was adapted for sequentially matching both cohorts. Difference-in-differences (DID) was used to compare mean changes in costs and utilization outcomes between cohorts.

RESULTS: After matching, 13,193 beneficiaries in each cohort were used for analysis. Mean outpatient, emergency, pharmacy, and total costs increased before and after enrollment for both cohorts. No significant DID in costs were observed between cohorts. Healthcare utilization mean DID were significantly greater in the non-med-sync cohort compared to the med-sync cohort for outpatient visits (DID: 1.17, p<0.0001), emergency department visits (DID: 0.03, p=0.0372) and pharmacy fills (DID: 1.93, p<0.0001). There was no significant DID for inpatient visits between cohorts.

CONCLUSION: Outpatient, emergency, and pharmacy utilizations changes were significantly higher in the non-med-sync cohort compared to the med-sync cohort in the 12-months after enrollment. Lower pharmacy utilization could be due to optimization of therapy during medication reviews of ABM med-sync.