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Prescription price transparency helps patients gain financial flexibility, proactive provider care

by Dignity Health

Published on 3/20/2019

As the price for prescription medications soar to alarming heights, patients are often forced to choose between purchasing the medication and following their treatment plan, or simply not filling the prescription because they cannot afford it. At San Francisco, California-based Dignity Health, a drug pricing transparency tool is alleviating that financial stress for its patients.

With Real-Time Prescription Benefits — a Cerner solution powered by Surescripts — embedded in the EHR workflow, transparent conversations can occur between a patient and his or her physicians. A physician can see how much a patient should pay for a prescription drug when they prescribe it. That can also help the physician view cheaper alternative medications.

Program Director of the Family Medicine Residency Program, Willard Chung, MD, recalls one incident where he used information from one patient’s electronic health record (EHR) to inform her that her prescription drug co-pay would be less than $10. But when the patient went to the pharmacist, she learned it would be more than $200.

“My patient told the pharmacy they were wrong, and to go back and check with her insurance company,” said Dr. Chung. “The pharmacy checked again and told my patient she was right.”

“Using this solution, I saved my patient nearly $200 in an errant co-pay charge, while filling the prescription and staying compliant with her medications,” said Dr. Chung. “The price transparency capabilities allowed me to arm her with the information she needed while keeping her compliant with our therapeutic plan.”

Prior to the Real-Time Prescription Benefits solution — added as part of the broader Cerner Millennium® update in May 2018 — Dr. Chung’s patient either would have paid an exorbitant copay or might have declined to fill the script.

With the original prescription cost, along with cheaper alternatives and patient copay details listed in the EHR workflow, a physician can make the most informed decision possible. Other early successes at Dignity include 145 total drug swaps, with 95 unique physicians completing at least one drug swap each; 14 brand name drugs switched to generic drugs and 46-day supply changes (or number of days the medication supply will last). The average consumer savings per drug swap totals nearly $328.07 and helped saved consumers an estimated more than $47,000 in the first eight months.1

This transparency works in tandem with existing formulary to narrow down the necessary therapy and provide prescribers instant cost, coverage alerts, details, alternative medications and options supporting clinical decisions. The physician gains a clear understanding of prescription and co-pay costs, which can reduce variables resulting in gaps with drug adherence.

“I probably wouldn’t have even known about the medication non-compliance, so this is a win for the physician-patient relationship as well as the care of the patient,” said Dr. Chung.

1 From May 2018 – February 2019

For more information about best practices for ePrescribe, visit our Model Experience Page.

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.