Drug prices are bankrupting employers. This isn’t new. A lack of transparency, fuzzy math, and back-door deals have overwhelmed the pharmacy industry, and responsible parties are too busy pointing fingers to find solutions. However, finding pharmacy savings may be simpler than many people think. Savings solutions need to start at the source: the doctor.
After all, doctors write the prescriptions.
With the right information, most conscientious doctors will make the right prescription choice for cost savings and patient well-being. When self-insured employers engage doctors with safe drug alternatives, true costs, and quality of care options, those doctors can make more cost-effective decisions. Doctor engagement opens patient-doctor communication, educates doctors on drug alternatives, and battles big pharma marketing.
Discussing prescription drug affordability in the doctor’s office is not common practice. In fact, a recent study showed that fewer than 44% of patients say their physicians advised them on the costs of medication or offered lower-cost alternatives.
Affordability is a real issue for patients. Seventy-three percent of patients would change pharmacies to save money on prescriptions. Thirty-eight percent would switch pharmacies for as little as $10 in savings, and 70% would switch for savings between $11 to $25. In-office discussions about prescription costs would limit sticker shock, allowing patients to make more economical spending decisions and improving patient adherence.
Engagement at the source also provides doctors with education on prescription costs and available alternatives to high-cost drugs. Many patients assume their doctor knows the cost of drugs and simply accept the financial burden of filling that prescription or vary from the recommended treatment plan by taking less medication than prescribed. However, doctors often do not know the true cost of the medication they are prescribing. With growing patient loads, shorter appointment times, and incomplete prescribing guides, doctors are writing more prescriptions based on pharmaceutical marketing information.
Some insurance companies and health systems are working to put drug pricing information in front of members’ doctors to lower drug costs for their members and plans. These pricing tools, embedded in the patient’s electronic health record, are a great step toward educating physicians, but only 10% of doctors are utilizing these tools when they are available.
A more effective method of doctor engagement would include a human element. While it seems relatively simple to access an online database to look up drug alternatives, a dedicated care team or savings advocate would be better situated to offer patient-specific drug pricing education to doctors and to develop a relationship of trust with doctors and their patients. Broad-reaching doctor engagement strategies that utilize care teams would also make drug pricing more widely accessible outside the health systems and insurers who use computer-based pricing tools.
While the costs of drugs are not readily available to doctors, the names of flashy, new brand name drugs are being constantly peddled by pharmaceutical reps. Big pharma marketing is one of the leading indicators of high brand-name prescribing rates, especially when that marketing includes payments to doctors from pharmaceutical companies.
For example, a study by ProPublica showed that internists who received no payments from pharmaceutical companies prescribed brand-name drugs 20% of the time compared to a 30% prescribing rate by doctors who received more than $5,000 from pharma companies. In an industry inundated by the “next big thing,” it is difficult for doctors to be completely immune to big pharma marketing. However, with complete pricing information readily available, easily accessible, and offered by a trusted partner, doctors will put patient’s needs first.
Engaging doctors is a unique approach to battling rising drug prices. It is not big pharma, the insurer, the plan sponsor, or the PBM holding the prescription pad. True, lasting pharmacy savings start where the prescribing starts: with the doctor.