The focus on lower drug costs has expanded to include providing drug price transparency to physicians and patients. This effort includes a January 2021 Centers for Medicare and Medicaid Services (CMS) requirement for Medicare Part D plans to support Real Time Prescription Benefit (RTPB) information to physicians in their Electronic Health Record (EHR) system.
It’s well known that high drug costs prevent many patients from receiving the treatments they need or require patients to sacrifice other necessities to pay for their prescriptions. “Physicians see every day that costs are a major obstacle to our patients getting the right medication at the right time,” said Dr. Jack Resneck, chair of the American Medical Association board of trustees.
Health benefit consultants can help their clients save up to $88 per member per year on prescription spending by sending actionable drug data to doctors. By partnering with BenMedica, consultants can reduce their employers’ and members’ Rx costs, increase medication adherence, and improve patient outcomes.
Employers and health plans are missing significant prescription savings opportunities available today through improved formulary and benefit data. Enhancing patient benefit data leads to better information at the point of prescribing, improves drug cost management, and creates savings now for both payers and patients.
Providing actionable information on generics options to physicians using Formulary and Benefit (F&B) data creates significant savings for payers, employers, and consumers.
Physicians have been conditioned to prescribe generics as part of first-line therapies to save patients money and eliminate callbacks requesting prescription changes. But, not all generic prescribing is equal.
Prescribing cost-effective specialty medications including those covered under a medical benefit requires physicians to have access to drug-specific information on plan coverage and restrictions. Currently, many physicians can only see that a medical benefit drug is not covered as part of the pharmacy benefit with no additional information.
