INTELLIGENCE IN ACTION

An Urgent Call for Transformation: Prescribers Need Better Information and a Streamlined Specialty Prescribing Process

May 21, 2019

Most likely, you or someone you love has been impacted by a complex or chronic illness like cancer or multiple sclerosis. Sadly, these diseases—and the cost of medications to treat them—are on the rise. More than half of specialty drugs cost in excess of $100,000 a year. As a result, spending on branded specialty medications is rising by 10 percent a year and is projected to surpass half of all medication spending by 2022, even though these drugs comprise just a fraction of all prescribed medications.

Naturally, healthcare providers want to start patients on their chosen medication therapies immediately. Yet they’re too often met with friction that can unnecessarily protract the specialty prescribing timeframe.



In fact, less than one-third of prescribers are either extremely or very satisfied with the efficiency of their organization’s current prescribing process. And according to our recent survey of 500 prescribers and our new data brief Provider Perspectives on Specialty Prescribing, when prescribers run into roadblocks along the way, nearly 70 percent change or reroute their orders.

From treatment delays caused by prior authorization, to a lack of trustworthy patient information at the point of care, prescribers are calling for transformation. Most prescribers said they don’t have digital access to patient information about out-of-pocket cost, lower-cost alternatives, prior authorization requirements and specialty pharmacy locations. And anywhere from half to three-quarters of prescribers said they don’t trust the information that they get manually.

This is a real problem today, and one that could reach a crisis point within just a few years.

Beyond the disturbing macro trends, I put myself in the shoes of a newly diagnosed cancer patient. I can imagine the added turmoil of being forced to wait to start my treatment. Whether due to prior authorization or an out-of-pocket cost that I cannot afford, this would be a critical moment in my healthcare journey. So I would absolutely be counting on my provider to quickly complete the prior authorization process and have information about a potentially cheaper therapeutic alternative at her fingertips.

At Surescripts, our history, scale and experience guide us first to understand the problems prescribers and pharmacists are running into on the ground, and then layer on the tools that smooth the process and speed the time to start therapy.

In the coming weeks, look for a series of brief articles drilling down into the specific insights healthcare providers shared in our survey about their experience with the specialty prescribing process.

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