Advertisement
01/21/2022

Solid solution: Five elements of an effective prescription pricing tool

Medication pricing information and tools providing drug alternatives that address shifts in care and patient needs could make the prescribing process easier.

Patients’ expectations about their care are creating massive changes in the healthcare industry — specifically pharmacies. However, in a recent survey, only 1 in 5 pharmacists said they felt “very prepared” for their changing role during COVID-19.

Image
Larry King, manager of clinical informatics, Surescripts
Larry King, manager of clinical informatics, Surescripts

As for patients, 19% said it’s become harder to afford medication in the past 18 months. Prescribers also saw a quarter of patients asking for a less expensive medicine while pharmacists saw 10% of patients walk away without their medications due to cost.

Pharmacists need solutions to address these shifts in care and patient needs, and many said medication pricing information and tools providing drug alternatives would make the prescribing process easier. As pharmacies look to obtain these solutions, here are five factors to consider:

1. Real-time, patient-specific benefit data at the point of care
Pharmacists want to make fully informed decisions together with their patients. That’s why an effective prescription pricing tool must include cost and coverage data sent directly from payers and integrate that information into the pharmacy’s software. The alternatives — estimates and third-party data sources — can leave too much room for error, resulting in pricing discrepancies that have lasting impacts across the entirety of a patient’s care. This broken trust becomes increasingly challenging when providing recommendations on therapy changes and patient counseling, as well as in the overall experience.

2. Protection of the prescriber’s choice of therapy and the patient’s choice of pharmacy
We’ve all been influenced to purchase one item over another because it either appeared at the top of a search platform or the product kept showing up on our social media feeds. But a prescription pricing tool should neither steer a prescriber or a patient, nor let outside interests promote or suppress a particular medication option, and it must protect the patient’s choice of pharmacy.

3. Information on therapeutic alternatives
To reduce costs and medication nonadherence, pharmacists need to see pricing for different, clinically appropriate therapeutic options. One survey found that 94% of patients who had not taken a medication due to cost said they would have been willing to take a less expensive alternative if it had been suggested. An effective prescription pricing tool will display viable, benefit-plan-approved therapeutic alternatives so that pharmacists can select an affordable option.

[Related: Surescripts, Diameter Health team up to simplify specialty prescribing, fulfillment]

4. Accurate flagging of medications that require prior authorization
Treatment delays can threaten medication adherence just as much as unexpected costs. One estimate found that 3 in 10 patients had not taken a prescription because it took too long to fill. An effective prescription pricing tool, integrated in the pharmacist’s software system, can empower pharmacists to seamlessly collaborate with patients to choose a clinically appropriate and affordable medication and expediting time to therapy.

5. Seamless transition into prior authorization
An effective prescription pricing tool should not only display when prior authorization is required, but integrate and automate the process. According to a recent survey of pharmacists, integrated electronic prior authorization was the top tool to make the prescribing process easier.

“One survey found that 94% of patients who had not taken a medication due to cost said they would have been willing to take a less expensive alternative if it had been suggested.”

Consumerism and digital access are transforming health care, and providers and technology companies are working together to serve a population that wants more convenient, connected and cost-effective care. When patient-specific information, such as prior authorization status, medication adherence and out-of-pocket costs, available electronically, pharmacists don’t have to step out of their workflows — or away from their patients. The right prescription pricing tool can help pharmacists and patients through the pandemic and beyond with up-to-date, interoperable technologies that improve patient outcomes and satisfaction.

    Advertisement
    Advertisement