Rising prescription drug costs is not an unfamiliar topic to the vast majority of plan sponsors. The message from advisors is to encourage members to be wiser consumers. Plan members often learn at the pharmacy counter that the Pharmacy Benefit Manager (PBM) or Insurer was not paying for the full cost of their prescription, either because the drug prescribed was not a generic, or because the script was not the first line therapy for a stated condition.
The discussion should start at the doctor’s office and not at the pharmacy counter, but even with the prevalence of Electronic Medical Records (EMR’s) privacy and data safe guarding concerns seem to limit the integration of these records with Insurance coverage information (particularly dependent coverage situations).
Doctors do not know drug prices and traditionally prescribe from a list of perhaps 300 common drugs versus the over 10,000 Drug Identification Numbers (DIN’s) in the coverage universe. Until this conundrum is resolved, it may be prudent for plan sponsors to provide tools to me members, so members can perhaps make wise decisions about the prescribed drug before even leaving the doctor’s office.
The most recent app based solution released just yesterday is called Drug Finder from the Reformulary Group, a leading, Canadian independent drug plan management company.
The other app based program that we actually like more is the Medavie Blue Cross Drug Cost Compare. The Medavie app is actually geared to treating health professionals and not consumers, but we like it because drugs are broken down into price bands, so one is able to see visually, what the impact is of being prescribed an alternative medication. This is particularly useful if the member is subject to a copay or coinsurance through their plan. The covered drugs categories is nowhere as robust as that of Reformulary solution, as it only covers the seven most common therapeutic categories.
DrugFinder™ App – For consumers
This App allows Canadians to search prescription drugs and look up the drugs that provide the best combination of clinical and cost-effectiveness. DrugFinder enables users to make informed drug choices based on scientific evidence and independent medical advice — thereby giving them greater control of their health.
How it works – DrugFinder is an online tool that searches the Reformulary®, a list of drugs reviewed and handpicked by clinical experts. Users can search by drug name or medical condition, find out how much of the cost is reimbursed, and look up if there is an alternative drug that works just as well. A new feature, users can now keep track of their medications in DrugFinder’s virtual Medicine Cabinet, and sign up for alerts about alternative drugs available and new drugs on the market, as well as other health-related information. The DrugFinder app is available on the Apple App Store and Google Play Store. For more information and to use DrugFinder, visit: www.drugfinder.ca
The Drug Cost Compare app for iPhone and iPad gives health professionals across Canada the ability to quickly compare the cost of drugs within the same therapeutic class, helping them choose the most appropriate, cost-effective option for their patients. When you prescribe medication for your patient, and more than one product is available, would knowing their costs help you choose?
- Compare the cost of oral drugs in the seven most common therapeutic categories
- Compare drug costs at a glance with colour-coded results ranking drugs from most affordable to highest cost
- View information about generic alternative availability and inclusion on most Medavie Blue Cross formularies
- View pricing information based on the province selected
- Can be used for patients with or without drug coverage
With Drug Cost Compare, a health professional can ensure patients are being prescribed a solution that fits their needs therapeutically, while also helping to lower their out-of-pocket expenses—whether they are covered by a drug plan with a co-pay or are without coverage altogether.
Medavie Blue Cross created this app as part of their efforts to help improve the affordability and sustainability of drug costs in Canada. When all stakeholders have access to accurate information, the thought is that they can all make informed choices with personal health and help set the future course for the healthcare system.
The Drug Cost Compare app is available on the Apple App Store.