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Introduction

The purpose of this activity is to allow students to practice solving prescription drug coverage issues and recommend an appropriate course of action. Students are provided with a patient scenario and profile, as well as a prescription insurance formulary and $4/$10 medication list. The case has a prescription drug coverage issue wherein students develop recommendations to help meet the health care needs of a patient, seeking the solution that is most affordable yet still evidence-based and therapeutically effective.

Learning Objectives
  1. Evaluate a prescription drug coverage issue.

  2. Recommend an appropriate medication using evidence-based medicine to help meet the health care needs of the patient in an affordable manner.

  3. Apply a patient’s prescription insurance plan formulary to recommend appropriate pharmacotherapy.

  4. Utilize a pharmacy’s $4/$10 medication list to guide decision-making and recommendations for appropriate pharmacotherapy.

  5. Justify medication recommendation(s).

  6. Identify appropriate references to support recommendation(s).

Foundational Knowledge Required

Pharmacists’ Patient Care Process, patient assessment, pharmacotherapy and clinical practice guidelines related to assigned medical conditions, use of drug information resources, various aspects of prescription drug insurance (eg, types of health/pharmacy insurance [public or private], formulary, copay, prior authorization, step therapy, insurance rejections).

Suggested Resources

Assignment Instructions

Each student will complete this activity individually and will need a computer to access additional resources.

Review the Patient Scenario and Profile and use the prescription insurance plan Formulary and the pharmacy $4/$10 Medication List to answer the questions on the provided Answer Sheet, including:

  1. Make a specific recommendation related to how the patient can afford the medication.

  2. Provide rationale as to why the recommendation listed above is the best choice for this patient.

  3. List the references(s) utilized to support recommendation(s).

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