RelayHealth Pharmacy Solutions and CoverMyMeds Implement Industry’s Most Accurate Real-Time Prescription Benefit Solution

When writing a prescription, providers strive to make decisions based on unique clinical situations and individual care plans developed in consultation with their patients. Providers face significant obstacles in this process, including a dependency on inaccurate or incomplete drug formularies, patient co-pay information and prior authorization requirements. This lack of insight causes medication fulfillment gaps, which often lead to costly non-adherence—adding up to as much as $280 billion in avoidable costs each year.[ref] (# "Annals of Internal Medicine. “Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review” December 4, 2012, Vol 157, No.11") [ref] (# "D.P. Goldman. “Pharmacy Benefits and the Use of Drugs by the Chronically Ill,” JAMA, May 2004")

Real-Time Prescription Benefit (RTPB) solutions that rely solely on formulary and benefit information to help physicians make a prescribing decision are limited in their effectiveness and accuracy. Additionally, RTPB solutions focused on meeting the needs of one stakeholder may fail to meet the needs of the provider and patient by presenting inaccurate patient cost-share information or overly complex treatment options.

In contrast, RxBC is focused on helping patients get the medication they need to live healthy lives by acquiring real-time patient benefit coverage information and actual out-of-pocket costs directly from the pharmacy where the patient will fill their prescription. RxBenefit Clarity also notifies the provider when a PA is needed to fill a prescription, and gives the prescriber the option to proactively initiate an electronic prior authorization (ePA). Accurate patient cost share information and formulary restrictions allow the provider to select the most appropriate therapy for the patient.

“RelayHealth Pharmacy Solutions and CoverMyMeds created the industry’s most reliable prescribing decision support solution based on years of research and long-term partnerships across the entire pharmacy ecosystem, including pharmacies, providers, payers and life science companies,” said Nathan Mott, president of McKesson Rx Technology Solutions. “Each year, RelayHealth Pharmacy Solutions processes more than 18 billion pharmacy transactions—RxBenefit Clarity puts similar functionality in the hands of the provider, enabling them to have more informed conversations with patients that help drive adherence. The solution is truly pioneering the future of prescribing decision support within the EHR.”

NewCrop, LLC will soon make RxBenefit Clarity available to the more than 64,000 providers using the NewCrop platform.

“RxBenefit Clarity empowers providers to make medication therapy decisions with their patients, eliminating barriers that often lead to prescription abandonment,” said Randy Barnes, Executive Vice President of NewCrop. “What makes RxBenefit Clarity unique is its extraordinary accuracy, delivering medication benefit transparency, including the patient pay amount and whether a medication requires prior authorization. Providing medication benefit information at the time of prescribing will enable providers and patients to make informed decisions together, considering affordability and benefit coverage before the prescription is sent to the pharmacy.”

RelayHealth Pharmacy Solutions’ and CoverMyMeds’ combined network includes more than 62,000 pharmacies, 500 EHRs, 700,000 providers and most payers. As a result of their network, RxBenefit Clarity can provide coverage for all payers without requiring payer-by-payer implementation or network alliances.

RxBenefit Clarity can be easily integrated into any EHR through an API. For more information, visit go.covermymeds.com/RxBC.

Those attending HIMSS18 March 5 – 9, 2018 can register for The Evolution of RxBenefit Transparency Lunch and Learn on Wednesday, March 7 at 11:15 a.m. in room 101 to learn more about RxBenefit Clarity, or visit CoverMyMeds at booth 4612 for additional information.