Is that medication covered by my health insurance? How much will it cost me? Can I purchase it somewhere cheaper? These are normal questions a patient asks themselves when being prescribed a new medication. What most patients don’t realize is that determining these answers is an impossible process to navigate.
As prescription costs continue to skyrocket in the United States, member cost-share also increases, resulting in patients and prescribers needing more prescription transparency at their fingertips.
Typically, prescribers rely on their electronic health records system for general, national formulary information. Since this information is not patient or plan-specific, it can be misleading.
Depending on the patient’s health plan and formulary, a medication could be a preferred low-cost option for one patient and not covered for another. The number of health plans and formularies a provider would need to know to accurately advise patients is exponential.
Each time a new prescription or refill is written, nurses and medical assistants must go through an inefficient manual process of calling the pharmacy, patient, and health plan to figure out if the medication is covered and at what cost. And if it’s not covered, what alternatives could be prescribed or what prior authorization form is needed to get a medically necessary exception for the patient. With all these obstacles, a user-friendly solution that provides patient-specific information is necessary.
With the Levrx Practice AppTM patient-specific, real-time formulary, medication history, and eligibility information is in the hands of the practice staff at the moment prescribing decisions are made. This includes the drug’s status on the formulary, prior authorization and other clinical requirements and the cost to the member and the plan.
This information is also visible to the patient via The Levrx Member App TM . Not only can they access a virtual medicine cabinet, but they can also view the status of their medication plan along with viable drug and pharmacy alternatives that give them the opportunity to save. In a study done by The College of Family Physicians of Canada and published by the NIH, 72% of participants shared that the cost of their prescription directly influences their choice to take it. With all this information, the prescriber and patient can make an informed decision that leads to improved workflows, lower costs, patient satisfaction, and improved medication adherence.
To further support medication adherence, Levrx and AdhereHealth have partnered together to deliver an enhanced, one-of-a-kind solution that further ensures patients are on the right medication, stick to their treatment plan, and stay healthy long term. This unique combined solution proactively identifies and prioritizes patients at high risk of non-adherence and engages patients and providers unlike ever before to improve overall health outcomes.