Expanding Digital Communication Pathways

Help Bob Get His Meds: Expanding Digital Communication Pathways to Bring Greater Savings and Transparency to Patients

By Miriam Paramore, President, OptimizeRx
Twitter: @OpRxTweets
HIMSS20: Visit OptimizeRx at booth 8300-29 in Orlando FL

My dad is visiting for a few days. He told me a story about one of his golfing buddies, Bob, who recently had some heart problems. His doctor prescribed something and when Bob went to the pharmacy, he was shocked to learn that it cost $8,000 for a 30-day regimen.

Bob didn’t get the medicine. Instead, he called his doctor and said, “I guess I have to die because I can’t afford this medicine.” His doctor had no idea of the medication’s cost. So, they started over to find a different approach.

Fortunately, as a tech community, we have the opportunity to improve this situation through power of information. One significant opportunity lies in the better utilization of data and technology across and among stakeholders to find and share drug savings, improve price transparency and better ensure medication adherence.

Within the framework of value-based care, medication adherence represents a significant piece of the puzzle when it comes to improving quality performance for optimal reimbursement. It’s increasingly recognized that medication adherence is as or more important than treatment itself – affecting quality of life, health outcomes and healthcare costs.

It’s obvious, but still I like to say, “You can’t adhere to a medicine that you can’t afford to buy in the first place.” Prescription drug costs – and the rising cost of generic drugs – are forcing patients to choose whether to fill or take their medications as prescribed. Although there are some $7B worth of manufacturer coupons for prescription drugs available, only about 10% of them are actually redeemed. There’s a disconnect between the information about available coupons – on TV or print ads, or on company websites – and patients.

It is in this arena where technology can make a difference via the electronic distribution of drug pricing information and savings opportunities at the point of care. As a doctor is inputting a prescription, available coupons for a particular drug appear on the screen, and the provider can send it directly to the patient by email, text or in print. In this scenario, the doctor has the information he or she needs at the point of care to better partner with patients in their care, improve patient experience and set the stage for medication adherence.

To avoid problems like Bob experienced, doctors are increasingly interested in talking to patients about the cost of medications. In a recent survey of 642 U.S. physicians, most (86%) said they are comfortable discussing healthcare costs with patients, and over 90% said they believe they have a role to play in discussing costs with patients. The recent roll-out of the real-time pharmacy benefit transaction (a ping from the EHR to the PBM to check price) gives the doctor access to the breakdown of healthcare costs so they can help patients navigate their treatment options. And, if doctors also have access to coupon-based savings opportunities, they are even more equipped to help patients.

It’s stressful for patients to discover at the pharmacy that they can’t afford their medication. The technological tools exist to create drug price transparency inclusive of all savings available. Let’s use these tools and help Bob out.