By Tom Pasquariello, PharmD, BCPS, BCMAS, PRS
Blog Posts - 23 April 2019
Price Transparency solutions have been available for more than a year, and while this technology is already making an impact on patients, health care providers, and pharmacists alike, there remain many opportunities for improvement in this area. One of the most prominent is the relatively low level of patient understanding as to what information is available to their physician - and ultimately to themselves - in terms of their actual medication out-of-pocket cost.
With the adoption of solutions like Veradigm’s Price Transparency accelerating rapidly, now is an ideal time for patients to make a more conscious effort to take charge of their healthcare, as they learn about the many options available to help them to meet the challenges of covering the cost of their prescribed medications.
While there are benefits for physicians and pharmacists as well, to better understand the impact that price transparency can have, we need to start by seeing this challenge through your patient’s eyes.
Physicians are trained to select the best medication for a patient based on many other factors besides affordability such as clinical guideline recommendation, efficacy kidney function, drug-drug interactions, tolerability, etc.
Price transparency tools are designed to help close this gap by empowering physicians to help their patients understand how their real out-of-pocket cost can vary based on several factors including location of fill and payment method.
For example, if a patient has been going to Pharmacy A which is three miles away and paying $10 for a 30-day supply of a medication and Pharmacy B, just a mile away may offer the same medication for only $5. Over the course of a year, that is a patient cost savings of $60, not including the additional time and miles saved. Now consider how much could be saved if a patient is taking more than just one medication and you can begin to see how quickly these savings can add up to make a real difference in patients’ lives. New technologies such as Veradigm’s Price Transparency now provide the point of patient care insight that providers can use during the patient’s visit to help them save money and time when buying their medications.
As with physicians, some patients also think pharmacists make more money if they sell higher priced medications. There are also misperceptions about the role of a pharmacist in setting the price that the insurance sets for the patient. Pharmacists do not set the amount that the patient pays. A primary goal of pharmacists is to make it as easy and safe as possible for patients to take their medications, as prescribed, as that is the most likely path to successfully adhering to their care plan.
Price transparency tools can now help patients understand not just where their lowest cost option is, but what the right option is for them. Frequently, patients do not want the cheapest possible option. Other considerations when deciding on a pharmacy include convenience, staff quality, flexible hours, availability of drive-thru, proximity to home or work, and advanced technology such as apps. Other patients may prefer the medication to be delivered to their home because they do not have consistent transportation or may have a disability. I personally like a 90-day supply so that I do not have to pick up my medication as often, but others may not be able to pay for 2-3 copays at one time and may prefer it broken up into smaller amounts over time. The path to adherence is different for each patient.
Technologies such as Veradigm’s Price Transparency are helping place patients in the driver’s seat by delivering the knowledge they can use to affect their healthcare directly. It is up to patients to change the dialogue with their physician, to speak up and ask for their physician’s help in making an informed decision when it comes to the medication, the location, and the cost. In doing so, physicians can build trust, credibility, and loyalty with their patients, they can see firsthand the effects of price transparency from the point of care to their everyday life.
For more information on how to obtain Veradigm Price Transparency for your practice, visit our Veradigm ePrescribe page at www.veradigmhealth.com/ePrescribe.