Patients also meet friction when deciding how to receive their prescriptions. They often ask: “should I get this medication delivered to my home, or should I pick it up at the store?” There is often a lack of data provided to them about what a medication might cost via different fulfillment options. Patients should be able to trust that they have been prescribed the most cost-effective medication option at the most convenient location, but in most cases, they are not given any medication-specific information until they reach their pharmacy. Displaying and communicating accurate pricing and fulfillment information earlier in the care journey is often the difference between patients picking up their medications, or abandoning them altogether.
Real-Time Prescription Benefit (RTPB) Technology and Alleviating Prescription Friction
In many cases, providers prescribe medications they are familiar with and follow the path of least resistance when completing a prescription order. However, new tools are allowing providers to access formulary-driven information on medication alternatives, know which drugs might require PA, and view the cost of each option – all within the EHR. This technology – commonly known as Real-Time Prescription Benefit – is becoming readily available for care teams, and is eliminating many of the friction points throughout the prescribing process.
First, providers no longer need to search – inside or outside of the EHR – for insurance or coverage information on each patient. RTPB connections bring formulary data to the provider’s fingertips so they can view medications that are covered under the patient’s plan, as well as restrictions associated with their order. Instead of making the PA process simpler or faster, RTPB can help care teams avoid PAs altogether by displaying flags on restricted medications, and recommending medications that fall in the same drug class but do not require PA. Further, if lower-cost alternatives are available, RTPB can present those options for selection. There are no new systems to learn or websites to access. All of the patient coverage information is shown directly in the EHR when placing the medication order, and selections can be switched with just one click.
Next, providers can be confident that patient data is accurate and specific (when using RxRevu’s RTPB tool), since it is being pulled in real-time through direct connections to the nation’s largest PBMs. RxRevu has worked tirelessly to build transaction pipelines that transmit data on more than 120 million patients across the country. This data takes into consideration patient copays and deductibles, and helps display the actual price a patient will pay at the pharmacy. If coverage information isn’t available for a specific patient, we are able to display GoodRx pricing to maintain a consistent and positive experience for both the patient and provider.