The price of a medication is a major factor in a patient’s willingness – or ability – to adhere to their prescribed treatment plan. But unlike nearly every other product a consumer might purchase in their typical day, the price of a medication is often unknown until checking out at the pharmacy counter.
While legislation is driving much of the urgency around prescription price transparency, patients still reach the pharmacy not knowing what they might owe. Pharmacists must often deal with the additional work and frustration of getting patients on affordable treatment plans. Fortunately, there has been a recent push from providers asking for decision support tools to make the prescribing process more seamless and transparent.
In order to more deeply understand the provider perspective, RxRevu commissioned a survey of ambulatory practice providers to look at their current use of prescription decision support tools, what information they want at the point-of-care, and how they would benefit from having best-in-class Real-Time Prescription Benefit (RTPB) solutions.
The good news is that RTPB solutions are becoming more popular across the country. These tools bring coverage information to EHR workflows, allowing providers to have informed conversations with their patients about the cost of medications – before they reach the pharmacy.
Getting access to RTPB is typically simple, and vendors can often turn on prescription data feeds directly within the EHR. As explained by one provider in a follow-up interview, “having this information would make conversations more data-driven. It certainly would limit the number of follow-ups where a person abandons a prescription.”
But having access to RTPB is not enough. Providers need trustworthy data so they can avoid downstream work like prior authorization clearance or pharmacy callbacks when a patient refuses to pay for their medication. What the research shows is that not all RTPB solutions are created equal. Some display patient-specific medication costs to providers, while others show more vague, obsolete information.
Of those surveyed, over three quarters (77%) reported that they frequently must change, manage, or resend a prescription order once it has been sent to the pharmacy. This is likely due to a lack of accurate data at the point-of-care. As one provider explained, “access to health plan formularies is not enough. Each health insurer has multiple plans, a source of confusion for providers trying to stay up-to-date on ever-changing guidelines.”
While 93% of providers surveyed said that they would switch a patient’s medication order because of formulary or coverage restrictions, only 10% trust the medication information presented to them. There is clearly confusion in the industry about what exactly RTPB is and what it should accomplish.
These survey results demonstrate that there is an indisputable desire for more accurate information at the point-of-care. While there are a number of RTPB vendors in the market, RxRevu is dedicated to delivering an RTPB solution that meets provider needs. The RxRevu team works closely with health systems, PBMs, and EHR vendors to deploy the most accurate RTPB solution in the market. With direct connections to PBM data sources, pricing information displayed at the point-of-care is not only patient-specific, but it takes into consideration copay, deductible, and coverage status, and is the actual price a patient will pay at the pharmacy. RxRevu also fills coverage gaps left by other RTPB vendors to improve the provider workflow, reduce pharmacy callbacks, and create a more positive prescribing experience.
While some providers lack the tools necessary to discuss medication pricing at the point-of-care, others are simply looking for better information to improve patient conversations and adherence. Download the full whitepaper to learn about the current state of prescription decision support technology and how RTPB tools can improve the prescribing workflow.
To learn more about RxRevu’s best-in-class price transparency solutions, check out RxRevu.com.
As seen on Becker’s Healthcare.