Background Expedited partner therapy (EPT) is commonly provided by prescription, however, the effectiveness of prescription-EPT has not been studied, and will depend on how often prescriptions are filled. We examined whether EPT-prescriptions get filled at retail pharmacies when the cost barrier is removed.

Methods Clinical sites diagnosing large numbers of Chlamydia trachomatis (Ct) infections and providing EPT-prescriptions were recruited. An industry partner developed voucher cards redeemable, with prescription, for free azithromycin, 1g, in any pharmacy in states where EPT is legal. Voucher cards were distributed to clinical sites. Providers prescribing EPT recorded index-patient age, gender, and prescription date on a tear-off tab accompanying each card, retained these tabs, and dispensed vouchers, along with EPT-prescriptions, to index-patients. A standard pharmacy interface captured unique voucher codes, prescription data, age, sex of the person redeeming the card. Pharmacy data were downloaded from an industry portal, linked with data from tear-off tabs, and analyzed. We considered redeemed cards a surrogate for filled prescriptions, and assessed patient and provider characteristics associated with redemption.

Results During September, 2017-June, 2018, 30 sites in New York City (NYC), New York State outside NYC, and Maryland enrolled; 580 EPT discount cards were dispensed by providers and 40% (234/580) redeemed at pharmacies. Redemption differed significantly by: index-patient gender (women, 44% versus men, 32%, p=0.005), and age in years (<18, 23% versus >18, 45%, p<0.001). Most cards (57%) were redeemed same-day. Among sites dispensing >10 cards, redemption was 41% (212/521), range 6–78% (median, 36%); redemption of cards distributed at STD clinics was 38% (51/136). After excluding a high-volume site with an onsite pharmacy, there was no association between index-patient gender and card redemption.

Conclusion Less than half of EPT-prescriptions were filled, despite medication being dispensed for free, suggesting prescription-EPT to treat Ct may result in low partner-treatment rates, especially among adolescents.

Disclosure No significant relationships.