Friday, February 11, 2022

Clear Connections for Equitable Medication Access

Today’s guest post comes from John Beardsley, Senior Vice President of Corporate Strategy at CoverMyMeds.

John discusses some of the findings in CoverMyMeds’ recently published report on medication access. He describes patient-centric, data-driven solutions to help patients access, afford, and adhere to their therapies.

To learn more, download CoverMyMeds’ 2022 Medication Access Report.

Read on for John’s insights.

Clear Connections for Equitable Medication Access
By John Beardsley, Senior Vice President, Corporate Strategy, CoverMyMeds

Over the last two years, healthcare evolved to address fluctuating demands. The COVID-19 pandemic gave urgency to personalized, digital healthcare access. Through adaptation and flexibility, new care models born from the pandemic could continue to transform healthcare.

The CoverMyMeds 2022 Medication Access Report, published this week, details how the industry can embrace more accessible data to address patient disparities and inequities for proactive, patient-centric healthcare. This annual report compiles new data, industry insights and real patient stories to address how technology can help sharpen the focus on a healthier, smarter, more equitable medication access system.


Each patient has a different set of variables that affect access, affordability and adherence to medications. Many of the most important variables are often missing in care team solutions, from patient-specific benefit information to social determinants of health. This means providers often don’t have a full dataset to hold productive conversations about treatment and financial care plans.

While healthcare has made great strides in digital access and broader care options, patients still faced medication access barriers over the last 12 months.

A common theme for many patients was care and prescription delays. Eighty-four percent of patients had to delay or forgo in-person healthcare visits. In the last 12 months, 82% of patients experienced a delay in receiving their medications, a 9 percentage point increase over the previous year.

Care teams can help patients get ahead of factors that may cause medication delays or care interruptions. To do this effectively, they need more time, but they have less of it than ever due to staffing shortages and increased patient and responsibility load. Fifty-four percent of pharmacists felt they didn’t have time to do their job effectively, most often citing staffing shortages and administrative tasks.

Interoperable technology can help create this time by automating manual processes like prior authorization (PA) and pulling in patient-specific benefit data. While many providers and pharmacists may have electronic solutions to manage PA and benefits verification, 28% of providers still use phone and 26% fax to submit at least some PA requests. However, more providers are helping patients get ahead of PA delays, with 25% of providers submitting PA requests from their EHR, an increase of 8 percentage points over 2020 and 18 in 2019.

Integrated ePA solutions within EHRs and pharmacy systems allow providers to start PA requests early and allow real-time updates for pharmacists. When providers start PA requests at the point of prescribing, patients can get their medications nearly two weeks sooner, on average, compared to requests started at the pharmacy (MetroHealth Case Study, 2017).


Patients seemingly have more options than ever to help lower their medication out-of-pocket costs. Often, however, these options aren’t always visible to the right provider or pharmacist or in the right place in the patient journey. Without cost or affordability options in front of them, patients may not know what to expect. In the last 12 months, 79% discovered their prescription cost more than expected at the pharmacy, up from 67% last year.

More patients in the last 12 months also made difficult tradeoffs between their treatment and life essentials. Fifty-two percent of patients gave up life essentials to better afford medications, up from 43% last year; 51% sacrificed medications to better afford life essentials, up from 36% last year; and 56% modified treatment to stretch out prescriptions, up from 41% last year.

While nearly half of patients said they lean on providers and pharmacists to help them find affordability options, only 25% of providers and 36% of pharmacists have patient-specific benefit information available within workflow. Broader interoperability can help ensure data flows to each care provider for responsible prescribing and improved patient affordability potential.

Transparent connections and interoperable technology can also help with patient starts (first-fill adherence). In one study, a real-time prescription benefit solution resulted in 88% of prescriptions being filled at the pharmacy (RelayHealth Partners data on file, 2021).


Maintaining medication access can come with its own set of challenges, including factors outside the benefit and clinical realm, such as social determinants of health.

Human intervention is often the best approach in addressing these challenges, which is why technology to automate manual processes is critical for medication adherence. Automated enrollment, expedited processing and electronic connections to services such as transportation, housing and employment aid can allow care team members to elevate value-based patient care.

In fact, hands-on, medication-specific clinical support can help patients experience a 25% increase in therapy adherence and 31 more days on therapy.

Clear connections to data and the right resources can help care teams continue to keep patients at the center of everything they do.

Learn more about how patient-centric healthcare technology is helping overcome medication access barriers in our 2022 Medication Access Report.

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