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How can employers and unions manage the rising costs of prescriptions?

by Erin Smith

Published on 1/27/2020

Estimated read time: 4 minutes

About 49 percent of the U.S. population receives employer-sponsored health insurance. The rising cost of pharmacy services is a major challenge facing organizations that are trying to manage the health of their workforce and lower their health care spend. With the Centers for Medicare and Medicaid Services projecting that prescription drug spending will outpace all other aspects of health care over the next decade, this is an issue that becomes more pressing every day.

Erin Smith, manager and senior pharmacist for Cerner’s four on-site pharmacies, joined the “Perspectives on Health and Tech” podcast to share her expertise on the impact that pharmacy costs have on organizations looking to manage the health of their workforce. She also provided some practical steps that organizations can take to help mitigate these costs.

Read highlights from the episode below, and listen to the full conversation here.

Q: What can organizations do to address the rising costs of prescription drugs?

A: There's a lot of different ways that employers and unions can contain their drug spend. The easiest way to start is by making sure that the health plan is designed to incentivize employees or members to make decisions that can help lower costs. It can be something as simple as reducing the co-pay on generic medications or adding in a prior authorization program to ensure that the most cost-effective medication is being used.

Another step is to partner with a specialty medication distributor. They tend to get better pricing on specialty medications, and their pharmacy team are experts in that field. They're able to monitor the patients closely, help them with any issues, and make sure the medications they are on are the right ones to help them meet their goals.

The next thing, which is near and dear to my heart, is on-site pharmacies. Having a dedicated pharmacy team that can work with providers to make sure that they're making cost-effective prescribing decisions, work closely with patients to make sure that they understand their medications and how to use them correctly is a great way to lower costs and improve outcomes.

Lastly, having a team of care coordinators in place who can help employees better understand the benefits in the programs that are available to them can have a significant impact on lowering costs. An employer can provide great health and wellness programs, but if employees aren't using them, the organization won’t get the results they want.

Q: What results have you seen from organizations that are practicing the strategies that you mentioned?

A: One of the first things we see is better medication adherence, and when patients are taking their medication as prescribed, it can lead to lower overall health care costs.

In addition, we've seen an increase in the use of generic medications within our pharmacies. This is partially because on-site pharmacists are able to talk with patients about the difference between a generic and a brand name and why it's OK to use a generic. It’s also because these pharmacists take the time to reach out to providers to explain to them why a generic option might work better. These are easy, fast things to do control drug spend, but you need a team that's willing to take the time to have those conversations on behalf of your workforce.

Q: Do you have any predictions on where on the industry is heading?

A: Right now, there's a big drive towards medication therapy management ─ pharmacists spending more time interacting with patients one-on-one to help them better understand their health conditions and the medications used to manage them. I think in the next five years, we’ll see more pharmacists moving out from behind the counter, building relationships with patients, and playing a bigger role in improving the affordability and quality of health care.

Cerner’s on-site pharmacy services can help lower what you spend on prescription drugs while creating a more personalized experience for your employees. Learn more here.