Edward discusses the impact of providing access to drug price transparency and affordability programs to healthcare providers and patients at the point of care.
To learn more about AssistRx’s solutions, visit AssistRx.com.
Read on for Edward’s insights.
The Importance of Immediate Drug Price Transparency
By Edward Hensley, Co-founder and Chief Commercial Officer, AssistRx
According to IQVIA Institute for Human Data Science’s 2020 report, prescription abandonment rates are less than 5% when the prescription carries no out-of-pocket cost; it rises to 45% when the cost is over $125 and to 60% when the cost is over $500.
This trend is exacerbated by rising prescription drug prices. According to an AARP Public Policy Institute 2019 report, the average annual retail price of one specialty drug was nearly $79,000 in 2017, and retail prices have increased by an average of 226.4% over the last 12 years. Inflation increased by only 25.1% in the same period. The Kaiser Family Foundation found in 2019 that 1 in 4 Americans reported not being able to afford their medications, and 29% reported not taking their medications as prescribed due to cost.
These compounding factors are especially concerning when a patient’s adherence to therapy is critical to treatment outcomes. The impact of “sticker shock” is a challenge life sciences organizations must proactively address. If left unaddressed, the patient may either switch to a lower-cost therapy that may not have the same health impact or abandon their prescription altogether.
One of the simplest yet most effective ways to address this challenge is by providing access to drug price transparency and available affordability programs to patients and healthcare providers (HCPs) at the point of care. Accessing this information together enables patients and HCPs to make an informed decision on the best course of action, which can increase primary adherence and improve patient outcomes.
PURSUING TRANSPARENCY AND PATIENT-FIRST STRATEGIES
Drug price transparency and affordability has captured the attention of federal regulators and all stakeholders involved in ensuring patient success with prescribed specialty medications. This is evidenced by the previous U.S. administration’s “Transparency in Coverage” Final Rule, as well as a consensus among life sciences presenters at the 2021 JP Morgan Healthcare Conference to work with the new administration and Congress on affordability issues.
In addition to regulatory efforts, new, technology-first and consumer-centric players are entering the market, and existing players like AssistRx are establishing partnerships to facilitate price transparency. With these investments, it’s clear that this patient-first, consumer-centric trend is here to stay. By supporting insight into patient cost share at the point of care, life sciences organizations can be early adopters of this trend, as well as leaders in improving patient and HCP experiences and treatment outcomes.
IMPROVING ADHERENCE WITH REAL-TIME DRUG PRICE TRANSPARENCY
HCPs are now able to access prescription price transparency and electronically submit prior authorizations (PAs) in seconds from within their existing workflow by using tools like AssistRx’s Advanced Benefit Verification (ABV) and real-time e-PA. In fact, these solutions can be integrated into HCPs’ existing workflows via a comprehensive specialty therapy initiation portal—like iAssist, brand websites and the patient solutions CRM.
AssistRx’s ABV tool grants HCPs access to real-time comprehensive patient coverage, patient out-of-pocket cost, drug access restrictions, coverage alerts and fill options for all therapies including cash options.
The real-time e-PA tool provides HCPs with connectivity for more than 80% of covered lives in the market, along with PA status and tracking. HCPs using this tool benefit from ease of use, focused questions (meaning only relevant questions and response options are presented), and payer responses within minutes.
AssistRx developed these and many more modular e-support services to be able to integrate with iAssist, brand websites and CRMs. Specifically, HCPs can access the following:
iAssist: This HIPAA-compliant, Surescripts-certified platform provides HCPs with a one-stop-shop for all their prescribing and enrollment needs through a single, automated workflow. In addition to ABV and real-time e-PA, iAssist provides HCPs with real-time automation for e-consent, e-prescribing, e-enrollment, specialty pharmacy selection and more.
Brand Websites: Like iAssist, HCPs can also access many of AssistRx’s e-support services directly via the brand website. Patients may also access e-support services via the brand website including:
- e-Enrollment into patient support programs
- Electronic screening for copay and PAP
- Prescriber and facility look-up
- Travel/lodging receipt reimbursement
- Educational and local/national support resources
- Live chat with clinical and/or non-clinical staff
Regardless of HCPs’ workflow, there are now solutions that can provide them and their patients with real-time visibility into comprehensive prescription pricing and access barriers specific to the product and the patient’s plan. This critical offering, complemented by automated, real-time tools like AssistRx e-support services, facilitates informed decisions, improved outcomes and optimal experiences.
See what intelligent therapy initiation is all about. Learn more about AssistRx at assistrx.com.
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