Cost is a primary reason patients don’t take their medication as prescribed, resulting in poor patient outcomes and increased healthcare costs. Providers can use tools like Real-Time Prescription Benefit (RTPB) to better inform patients by checking medication coverage, discussing out-of-pocket costs, and identifying lower-cost alternatives when prescribing.
But what happens if the patient’s coverage isn’t found, the patient isn’t insured, or insurance doesn’t cover the prescribed medication? These situations happen about 45% of the time – resulting in an affordability crisis that lowers medication adherence and creates additional work for providers when they are asked to help patients search for different ways to afford their medications.
Enter Patient Affordability Programs
Fortunately, a variety of programs, which we call patient affordability programs, are available to help patients afford the medications they need. Specific examples include pharmacy cash pay programs, prescription discount cards, and manufacturer co-pay assistance programs, among others.
As any savvy consumer knows, you have to shop around to find the best cost. And the challenge to date is that there hasn’t been an easy way for providers or patients to do this. As a result, patients lean on providers for help, asking them to search third-party websites or applications for ways to lower medication costs (not an ideal use of the provider’s time). When patients don’t ask their provider to help, they run into a confusing world – not knowing what options are available or even where to start looking for options.
A Better Way: Using Technology to Reduce Time Spent Searching for Best-Cost Options
For any given drug, insurance coverage, and pharmacy choice, the lowest cost option will differ – and even that cost can change rapidly. When all of these options aren’t considered at the point of prescribing, patients lose because the best-cost option is likely not provided.
A better approach than searching site-by-site, or program-by-program is using technology to search costs across a network of partners (insurance providers, prescription discount cards, Rx coupons, and others) and then surfacing the best-cost results directly within RTPB results, directly in the provider’s EHR workflow. Even better is texting coupons or other affordability program details to patients for easy redemption.
Arrive Health has built this functionality into its RTPB solution. We look at insurance costs, prices across our Rx coupon network, and manufacturer co-pay assistance cards and then deliver the best options directly to the provider within the EHR workflow – and directly to the patient by text message. In a pilot, we delivered 11,500 coupons to patients, equating to approximately $170,000 in patient savings – all without requiring more time from the provider.
Bottom line: we do the hard work to search our network of partners and surface the best-price option to providers and patients – saving both time and money
Learn more
ConnectiveRx, Glic Health®, GoodRx®, SingleCare®, and Optum Perks™ are in our growing network of partners. Contact us to learn how we can help save your providers time and your patients money by surfacing best-cost options from them directly within RTPB results.
