How an EHR Prescription Benefit Tool Increases Price Transparency

In the US, pharmaceutical sales increased by nearly 8 percent in 2021, when compared to the previous year. Prescriptions are a major cost for patients and an important factor in treating short and long-term health issues.

The problem, for patients and their physicians is that the prices of prescriptions can change dramatically in a short period of time. And every patient’s cost for the prescription is dependent on their prescription coverage. Each insurance has their own pricing for every prescription.

For physicians and their patients, having access to the current cost of any prescription allows them to make informed choices about treatment plans. Physicians can choose alternative prescriptions or verify whether generic or alternative prescriptions are available.

Because there are variables that may change based on coverage, as well as the fluctuation of the pricing for the prescription, it can be difficult to have access to accurate information in real-time. This is where an EHR benefit tool is ideal.

In this post, we’ll discuss why prescription drug price transparency matters. You’ll learn how transparency tools allow for a more detailed view of costs in real time and how it benefits both providers and patients.

Why Prescription Drug Price Transparency Matters

According to the AMA, Johns Hopkins integrated a price transparency tool into their EHR and found that it meant better adherence and greater satisfaction for the patients involved. They noted that the ability for patients and physicians to make informed decisions about prescriptions led to an increase in patients filling their prescriptions and following the treatment plan. It saved patients money, as well, which meant a benefit in patient care and service.

This is something that we need to think about from the patient’s side. When physicians write prescriptions, the most important aspect is likely to how beneficial it will be to the patient’s overall health. But the cost can be a detrimental factor for the patient. Exorbitant pricing and prescriptions that are not covered by the patient’s current benefits can make these prescriptions unaffordable. Often leading patients to skip filling them.

For some patients, there are numerous monthly prescriptions to consider. This makes it essential for physicians to be able to see real-time information about the pricing for the individual patient so that they can verify affordability and/or find alternatives in cases where the cost is too great.

Cost is not a small consideration. In one survey, 50 percent of respondents indicated that they have declined filling a prescription due to the cost. The result of not following the prescribed therapy can be permanently damaging and even life-threatening for some patients. Nearly 80 percent of patients would benefit from pricing transparency.

How Price Transparency Tools Help Providers

For providers, prescription benefits tools offer one more way to help their patients increase their overall health and see better outcomes. For the physician and staff, this tool gives them access to the information they need on their patient and the specific coverage they have. They can find an array of choices that may be more cost effective.

These tools also make the administrative process much easier for physicians and staff. The prescription can be chosen through the physician’s EHR interface and prescribed electronically. It’s then sent directly to the patient’s chosen pharmacy, so they can often pick it up the same day.

With this information available in real-time, doctors can discuss options with patients if preferred prescriptions are too costly. Staff can help patients when physicians aren’t available. And all the information is stored with the patient’s medical chart.

For providers, this knowledge can be helpful in offering the best patient care. Historically, patients are not always forthcoming when they don’t follow treatment plans. They may be embarrassed by the fact that they didn’t take the medication and may not be honest if they cannot afford the prescription. These things may be difficult for the providers to see through a visit, especially if they’re just writing a prescription but not aware of the cost at the pharmacy.

Physicians and providers have found that being able to verify the cost and coverage in advance helps patients get the medication they need and improve outcomes. They also find that it’s an improvement in the customer service portion of patient treatment.

Benefits of Prescription Price Transparency

Prescription transparency is exceptionally difficult to achieve without the right tools in place. But with a good transparency solution, there are several benefits for the patients and the healthcare providers.

Here are a few:

Patient Adherence

When providers can see the cost of a prescription option in real-time, they have a good indication of whether its affordable for the patient. They can also ask outright if the patient is comfortable with the prescription cost. Working together with pricing in the equation helps the patient find the right medication that will work for their health needs but that is affordable for their budget. This dramatically decreases the percentage of patients who forego filling prescriptions based on budget constraints.

Give the Provider More Understanding of Patient Coverage

Providers in the past may not have known why patients weren’t taking medication or following treatment plans. With tools to see the current cost of prescriptions through the patient’s plan, they can put this information together with other aspects of the patient’s medical history. It helps them get a bigger picture so they can more proactively look for solutions that fit the patient’s health and budget.

Improve Patient Satisfaction

When patients bring a prescription to the pharmacy, the first question they ask is often about the price. When providers can help patients choose their medication with price transparency, it alleviates worry over cost and help improve the experience overall.

Streamlined Administrative Process

The tools make the process easy for physicians and staff and more convenient for patients.

Key Takeaways

  • 50 percent of patients indicated that they have declined filling a prescription due to the cost
  • Nearly 80 percent of patients would benefit from pricing transparency
  • For providers, prescription benefits tools offer one more way to help their patients increase their overall health and see better outcomes
  • Prescription pricing tools allow providers and physicians to see real-time prescription costs to make informed budgetary choices
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