Evaluation of an Over-the-Counter Medication Program

Military Medicine, Jul 2004 by Huntzinger, Paul Evan

Survey

An OTC Program Usage Survey (Fig. 4) was developed to determine program use by active duty members. The survey was handed to active duty members (N = 53) between November 18, 2002 and December 19, 2002 when they presented to the pharmacy for OTC program items. Members were told the survey was anonymous (i.e., no personal identification information was requested) and strictly voluntary. Only one person declined to complete a survey. Members were asked if they previously had the opportunity to complete the survey and were not handed another one if they answered affirmatively.

Survey Results

Because the majority of survey results involved the interpretation of subjective data (Table II), there is the possibility that results were skewed from the statistical norm. If skewing of results occurred, it may have been extenuated by the limited survey period and a longer survey period could have mitigated this possibility. For this article, it was assumed that survey respondents (JV = 52) were truthful and the data represented the facts fairly. Raw data results reveal the ratios of female to male users was 1:2.5 (0.4) and of officers (including warrant officers) to enlisted personnel was 1:2.1 (0.48). On Coast Guard Island, the ratios of female to male active duty members was 1:4 (0.25) and of officers to enlisted personnel was 1:8 (0.125). Therefore, proportionally, females used the program more than males (p = 0.013) and officers more so than enlisted persons (p = 0.051). The survey also indicated that most active duty users of the program used the program for themselves, used it multiple times during the year, and, despite its limited scope, were satisfied with the program. Significantly, 39% of survey respondents (n = 19) stated the program kept them from making a medical appointment (p

The average monthly expenditure for OTC program items at the CGA pharmacy is $850 (2.3% of the monthly pharmacy budget). Because a total of 1,060 items are handed out monthly, the average direct cost per item is $0.80 (versus $4 in the civilian sector),6 thus, the total cost for providing OTC products to active duty members through the program averages $41.60 (based on two products per recipient). The cost of a medical appointment may be roughly calculated by determining the average monthly base salary (including housing allowance) of medical providers, assuming a 40-hour work week and allowing for the clinic standard of 20 minutes per nonphysical appointment. Using pay information in the public domain,7 the rounded average total hourly wages of all medical treatment facility (MTF) providers (three pay grade 05s and one pay grade 02) is $173 per hour, which translates to $58 per appointment. The actual appointment cost is probably closer to the mid-$60 range because of other factors affecting cost such as provider specialty pay, enlisted personnel salaries, supplies, and utilities. Thus, if the 19 survey respondents made medical appointments in lieu of using the OTC program, the cost (estimated versus actual) would be approximately $1,102. Moreover, these persons would have occupied 6.3 hours worth of appointment slots that could have been used for individuals with more pressing conditions. Thus, the direct cost avoidance by having the program was $1,056 for the study time frame.