Have you ever suffered from sticker shock at the pharmacy? You arrive with a prescription from your doctor, but you are told that the medication is not covered and could cost you several hundred dollars. Health insurance and prescription drug coverage is a complex puzzle, and many consumers find themselves at a loss to understand what is or isn’t covered and why.
However, some companies are trying to make the process easier. In particular, services to educate doctors and patients about drug benefits right in the doctor’s office can help avoid unpleasant surprises at the pharmacy.
One example is a new drug benefit service available from Humana’s IntelligentRx service, available to physicians through DrFirst’s electronic prescription system. It provides doctors with details about their Humana patients’ drug coverage, pricing and pharmacy options on the spot in the exam room. Doctors and patients can discuss and review drug costs and options as the prescription is being written.
According to William Fleming, president of Humana Pharmacy, the ability to help doctors make informed prescribing decisions in the exam room can help improve clinical outcomes by improving patients’ access and adherence to their medications.
“Real-time information provided by the IntelligentRx service is a perfect example of how we can help doctors proactively deliver better care more affordably to their patients,” Fleming said. “This is a big step forward in closing the gaps in the health care system, using transparency and technology to create a better health care experience,” he added.
Here’s how it works: A doctor chooses a medication, and the DrFirst’s myBenefitCheck interface connects with Humana’s IntelligentRX service. The doctor sees information specific to his or her patient about drug costs and coverage, information about drug allergies and even alternative therapies.
Such programs could have a significant impact on health care costs, which are a known barrier to medication adherence. Based on data from the Centers for Disease Control and Prevention, approximately 125,000 deaths in the United States each year result from individuals not taking medications as prescribed.