Sometimes figuring out the price of a medication is like playing Plinko… you never know what you’re going to get. And while Plinko, Do the Math, and Time is Money are fun to play on The Price is Right, patients shouldn’t have to decide whether to play-or-walk-away when picking up their prescribed medications.
While we all wish we could get our medications for a bid of $1 (Bob!), it is simply not realistic to do so in most situations. What’s worse is that there is substantial evidence that the price of a medication is a major factor in a patient’s willingness – or ability – to adhere to their prescribed treatment plan. The challenge is that there are many factors impacting each patient’s medication costs, from specific plan details to copay and deductible information. Unfortunately, if providers do not have access to this information when ordering, they will continue to prescribe high-cost medications that may or may not be covered by the patient’s insurance.
Every year, more research is published that emphasizes the fact that high prescription costs drive non-adherence and negative health outcomes. For example, the CDC wrote that more than half of Americans have received a medical bill they did not have the funds set aside to pay for, and more than 10% of adults reported delaying or skipping care because of financial reasons. Further, a new study from researchers at Harvard University and the University of California at Berkeley, found that a 34% increase in cost ($10.40 increase, on average) led to a significant decrease in patients filling life-saving prescriptions, and a staggering 33% increase in monthly mortality!
Additional research on how increases in cost impact adherence and overall patient health have been written about in The Journal of Managed Care and Specialty Pharmacy, PLOS One, and Pharmacy & Therapy. The evidence is clear – when patients must pay more for their medications, they reduce the cadence at which they take that medicine or stop taking the medication altogether. The price needs to be right in order for patients to adhere to their treatment plan.
One common issue is that, just like all of the items up for grabs on The Price is Right, the price of a medication is often unknown until checking out at the pharmacy counter… until now. Real-Time Prescription Benefit (RTPB) tools display patient-specific cost and coverage information in the EHR workflow, helping providers view and select lower-cost medications, convenient pharmacy locations, and on-formulary options that might not require prior authorization. With RTPB turned on, providers can view reliable data and make informed decisions about which medications to prescribe based on a patient’s health status and coverage.
Finding the lowest-cost option for each patient no longer needs to be like a game of Plinko, or like any game for that matter. By turning on an EHR-integrated RTPB solution, providers can easily select medication options based on price, creating more scenarios where The (Rx) Price is Right.
To learn more about how RxRevu can help your teams select lower-cost medication options at the point-of-care, reach out today.