As many Americans continue to struggle to afford their medications, health insurers and their PBMs are responding with tools that help consumers not only understand the cost of drugs before prescriptions are filled, but also find ways to spend less money on them, AIS Health reported.
However payers choose to design such tools, two keys to their success include making improvements over time and making sure members know about them before they might need them, according to Nathan Foco, senior director of market and sales intelligence for Michigan-based Priority Health.
In late 2017, Priority Health began adding prescription drugs into its Cost Estimator tool to help members understand what they will pay for a prescription and how they could pay less by switching to a lower-priced alternative or opting for home delivery. Use of the prescription drug portion of the Cost Estimator has also increased since it was first rolled out, according to Foco.
“Like a lot of experiences like this, it takes a little while to get going,” he says. “You really can’t undercut the effort that you need to put into promoting and engaging members in the tool.”
Priority Health is not the only payer to offer tools that promote drug-cost transparency. Others include:
Cigna Corp., which in February said its network of health care providers will now have access to Surescripts’ Real-Time Prescription Benefit Tool, which gives them patient-specific medication coverage and cost information within their electronic health record or e-prescribing platform.
Blue Cross Blue Shield of Louisiana in February launched a tool called Rx Savings Solutions, which connects securely with members’ drug claim records and prepares a personalized prescription savings plan for them.
Aetna Inc. offers a tool that provides members with “real-time/moment-in-time drug pricing based on their benefit and status of their deductible,” according to a company spokesperson.
UnitedHealth Group’s OptumRx offers tools that allow enrollees to compare drug costs between generic and brand drugs, identify the lowest-cost option at an in-network retail pharmacy, or enroll in less-expensive home delivery of medications.