Prescription Price Transparency Helps Patients Engage in Health Care Decision-Making
Beyond improving prescription decision support for providers, RxBenefit Clarity has a direct, positive impact on patients. A recent CoverMyMeds survey conducted in partnership with SHC Universal and Research Now found that 75 percent of U.S. patients have received a prescription that was more expensive than they expected, and 50 percent did not fill the prescription because the cost was too high.
“Just as consumer behavior has evolved in the digital age, patients increasingly want to be more involved in their treatment plans. Having accurate visibility into prescription price information and available assistance programs plays an essential role in their decision making and medication adherence,” said Miranda Gill, MSN, RN, NEA-BC, Director of Clinical Innovation at CoverMyMeds. “Price estimations are often unreliable and can lead to prescription abandonment if the price at the pharmacy is more expensive than what was discussed by the provider and their patient.”
All-Stakeholder Solution Delivers Better Accuracy, Reliable Prescription Decision Support
Fifty-two percent of providers report having access to formulary information in their EHR. However, the average trust rating of that information is currently only 5.7 out of 10, indicating that providers may be skeptical of real-time benefit check solutions that only analyze formulary and benefit information. RxBenefit Clarity is the only solution that incorporates coverage information from the patient’s health plan as well as the pharmacy where the patient will fill their prescription.
RxBenefit Clarity takes an all-stakeholder approach to display the precise patient pay amount through comprehensive analysis, including the patient’s co-pay, insurance deductible, price at their preferred pharmacy, patient assistance programs, pharmacy cash programs and prior authorization requirements. If a prior authorization is required, RxBenefit Clarity is equipped with electronic prior authorization (ePA) functionality to proactively initiate a prior authorization request for any medication and all health plans. This is done by leveraging the networks of CoverMyMeds, the market leader in ePA, and RelayHealth Pharmacy Solutions, the nation’s leading pharmacy connectivity network, to bring health care providers, pharmacies and payers together to provide the most accurate, patient-centric real-time benefit check solution available today.
CoverMyMeds’ and RelayHealth Pharmacy Solutions’ combined network includes more than 62,000 pharmacies, 500 EHRs, 700,000 providers and nearly all payers. As a result of their network, RxBenefit Clarity will provide coverage for all payers without requiring payer-by-payer implementation.
For more information about RxBenefit Clarity, visit go.covermymeds.com/RxBC.