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Patient visibility into out-of-pocket prescription costs takes on added importance in January | BioPharma Dive

Between pending federal legislation on price transparency and the rising tide of patient self-empowerment, there has never been more focus on closing the gap between patients’ prescription out-of-pocket (OOP) costs and what they can afford to pay.

In January 2019, healthcare providers are rapidly adopting new technologies to help them to meet this growing demand with patient-specific cash pricing, formulary information, generic and therapeutic alternatives and patient financial assistance programs appearing directly within their existing electronic prescribing workflow. Prescription Price Transparency, from Veradigm™, has seen prescribers generate more than 15 million price transparency transactions covering 1.6 million patients in the U.S. since March 2018.

With the new year comes new patient insurance, new deductibles, and other information, all of which can be seamlessly integrated into a provider’s clinical workflow through price transparency e-prescribing solutions. The influence of these and other “new plan year factors” impacting medication price transparency, and the value to be derived from it, is the stimulus for this article.

January 2019 is an Especially Difficult Month for Providers to be Without Price Transparency
With price transparency solutions readily available (often at little or no additional cost to providers), practices that lack access to this information within their clinical workflow are at a disadvantage. This situation is exacerbated further every January, when patients begin a new year of insurance coverage that frequently includes changes to their insurance carrier, insurance plan, and/or formulary, as well as the resetting of deductibles.

Many price transparency solutions only deliver information to providers on the cash (non-insurance) pricing for the prescribed drug, and potentially generic alternatives as well. To provide a complete picture of their OOP cost alternatives, providers must also have access to real-time, patient-specific benefit, formulary and insurance data. The more complete and real-time the data, the better-equipped providers are to help talk their patients through their actual OOP costs, regardless of changes for the new year.

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Patient visibility into out-of-pocket prescription costs takes on added importance in January | BioPharma Dive.

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