Why does pharmacy have to be so difficult? There seems to be a huge disconnect and a lot of finger pointing when it comes to prescribing drugs. A patient goes to the doctor and at the end of the visit gets prescribed medication to address the issue. Patients accustomed to the drill start to sweat as they head to the drug store. Is the drug on the approved list? Is pre-certification or step therapy required? Is there a quantity limit? And the biggest concern – what’s it going to cost? Will it be $12, $120 or $1,200?
Pharmacy should be relatively easy. There is a formulary. There are utilization management rules and it doesn’t seem difficult to find out the cost, or at least the range of costs, for a particular drug.
As Adam Okun posted on Monday, CVS Health has announced that they will be launching a new software tool that will help. The CVS Pharmacy “Rx Savings Finder” will allow doctors and pharmacists access to a patient’s prescription data and insurance plan information in real time – doctors will no longer end up blindly prescribing a non-covered drug. And while I acknowledge the real pharmacy difficulties stem from deeper issues in the very opaque pricing system, I still feel that this app is a big step in the right direction.
Pharmacists will be able to easily check for and advise patients on therapeutic equivalents and available manufacturers coupons (even the cost of 30- versus 90-day scripts). This means no more standing around waiting while the pharmacist manually checks alternatives one at a time. And doctors can use the app during the office visit and decide to switch from an uncovered drug to one that is covered, eliminating a lot of wasted time, which CVS says occurs 85% of the time according to early app usage studies. Studies also show that 30% of the time a doctor using the app will switch from an already covered drug to a cheaper covered alternative, saving an average of $75 per switched drug.
Great start – now if someone can integrate the plan rules we could be seeing an incredible step forward in reducing friction. Once again, technology meets a problem and innovation results!