In November, nearly 250,000 doctors reviewed the cost of drugs they were prescribing to patients, according to a report by pharmaceutical information network Surescripts. That is up from 100,000 in January, Surescripts said, citing a report on usage of a price transparency tool that is embedded in electronic health record systems.
“This has been, by far, the fastest-adopted tool that we’ve ever created,” said Dr. Andrew Mellin, vice president of medical informatics for Surescripts, in a phone interview.
Source: SureScripts
Based in Arlington, Virginia, Surescripts operates an information network that links up clinicians, pharmacists, EHR vendors and pharmacy benefit managers. It introduced the prescription price transparency tool in November 2017 as a way to avoid sticker shock and other problems that prevent patients from getting the medications they need. The tool offers patient-specific benefit information to help inform decision-making.
“In the past providers have not had a good way to know what patients would pay for a drug they were prescribing,” Mellin said.
Prescription noncompliance, sometimes driven by cost, can result in poor health and higher healthcare spending, with studies putting the tab in the billions of dollars per year. It’s of course also financially beneficial for pharmaceutical companies when patients regularly fill their prescriptions.
Numerous companies and organizations have been working to address the problem of patients not filling their prescriptions and forgetting to take their pills. This spring, for example, patient-support services company Lash Group, part of AmerisourceBergen, partnered with Medisafe, maker of an app designed to track medication adherence. Investors, meanwhile, have backed startups like Wellth and Sempre Health.
The Surescripts tool, known as the Real-Time Prescription Benefit, brings up information in an EHR that doctors can use to gauge costs, identify potential obstacles and explore alternatives. If a patient goes to a pharmacy and can’t afford a prescription, he or she may simply not fill it. In other cases, prior authorization may be required from an insurer, which could lead to delays in getting prescriptions filled and create headaches for medical staff.
In a report on the tool’s adoption, Surescripts noted that 64% of clinicians report waiting at least a day for prior authorization, with some nurses reporting waits of nearly four days. Doctors who used the Surescripts tool switched 25.5% of the time to an alternative that did not require prior authorization, according to the report.
Cost, meanwhile, can be a problem for patients. A $10 co-pay raises the likelihood of prescription abandonment by 10%, according to the Surescripts report.
Doctors may hesitate to discuss a patient’s financial situation even when they have benefit information at their fingertips, Mellin acknowledged. “For many physicians, those conversations are not part of their routine and they can be uncomfortable.”
But, he said, numerous organizations are helping physicians and medical practices broach the subject. He cited work being done by the American College of Physicians and the Robert Wood Johnson Foundation, which is funding research into best practices for discussing the costs of care.
About 85% of U.S. prescribers have access to the Surescripts tool at no additional cost, Mellin said. Surescripts is working to extend it to the remaining 15%.
The heaviest users are in Washington, D.C., where nearly half, or 49.9%, of e-prescribers use it, according to Surescripts. The nation’s capital is followed by Maryland (48.5%), Delaware (44.3%), North Carolina (36.4%) and Louisiana (36.2%). The least-frequent users are in New Hampshire (11.1%), Washington (10.2%), New Mexico (9.3%), Massachusetts (8.8%) and South Dakota (8.3%).
Photo: gerenme, Getty Images
