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Surescripts Real-Time Prescription Benefit Saves Patients up to $8,032 on a Single Prescription, Reduces Prior Authorizations and Saves Thousands of Hours of Wait Time

ARLINGTON, Va. – Dec. 3, 2018 – Surescripts released new data revealing the significant impact of its benefit optimization tools, which have realized measurable cost and time savings for patients and providers. Prescribers utilizing Surescripts Real-Time Prescription Benefit saved patients as much as $8,032 in out-of-pocket costs on a single prescription. Further, when prescribing a medication requiring a prior authorization and presented an alternative without a prior authorization, prescribers switched the drug 24 percent of the time—eliminating more than 132,000 hours of potential wait time in one month.

“The Surescripts Network Alliance® is meeting the needs of healthcare providers and patients who expect their healthcare experience to be as seamless as online shopping,” said Tom Skelton, Chief Executive Officer of Surescripts. “Our unique offering is improving the prescription decision-making process by delivering accurate prescription price and therapeutic alternative information to the point of care, while staying true to the patient’s formulary and protecting patient and prescriber choice.”

In one instance reported by Express Scripts, a prescriber used their electronic health record (EHR) software to select an appropriate therapy to treat a patient’s ulcerative colitis as well as to select the patient’s preferred pharmacy. Leveraging Real-Time Prescription Benefit, the prescriber saw that the requested medication would cost the patient $1,361.40, but that a generic therapeutic alternative was also available through the patient’s pharmacy benefit plan for just $4. As a result, the prescriber changed the order, saving the patient $1,357.40.

“With Real-Time Prescription Benefit and Electronic Prior Authorization we are making healthcare more affordable and less complex for our members, all while helping achieve better health outcomes for patients,” said Lynne Nowak, M.D., Chief Physician Experience Officer at Express Scripts. “With real-time access to patient information at critical points in the care continuum, we can help providers direct patients to the most clinically appropriate and cost-effective therapy.”

Specialty-specific health information technology leader Modernizing Medicine offers Surescripts Real-Time Prescription Benefit to provide upfront cost transparency that can reduce surprises at the pharmacy and benefit both patients and clinicians. The company appreciates the clear and concise patient-specific benefit information that is pulled directly from pharmacy benefit managers (PBMs) and delivered to its EHR system, EMA™.

“With Real-Time Prescription Benefit, we are able to help our patients make educated decisions on their current prescriptions based on their finances,” explained Paula Ubelhor, an insurance and billing manager at Randall Dermatology in Indiana. “With this feature in Modernizing Medicine's EHR, we reduce the amount of time staff spend on the phone with pharmacies and helping patients identify more affordable medication alternatives.”

EHR vendors representing 77 percent of the market have signed on to offer Real-Time Prescription Benefit to their users. To date, prescribers have used the tool 30 million times to view patient-specific and formulary-based benefit and cost information. This information is provided directly by leading PBMs and health plans for 70 percent of U.S. covered lives.

“We are excited to be teaming with our longtime partners at Surescripts to deliver medication price and real-time benefit data to physicians and other prescribers using Practice Fusion EHR, Veradigm ePrescribe and many other leading clinical software platforms,” said Tom Langan, Chief Executive Officer of Veradigm (formerly Allscripts Payer and Life Sciences division). “Stakeholders across healthcare have long known how powerful this data could be, if made available to the right people at the right time and place. This is why Veradigm has made medication affordability such a priority, and why we are so pleased to see patients realizing such positive results.”

Prescription costs continue to make up a significant portion of U.S. healthcare costs, totaling 17 percent of overall personal healthcare services. Even when a drug is covered by insurance, high out-of-pocket costs can threaten adherence. Additionally, if that drug requires prior authorization, treatment can be delayed or abandoned entirely. Surescripts Real-Time Prescription Benefit allows prescribers to access benefits-based, patient-specific out-of-pocket cost, prior authorization and therapeutic alternative information directly within the EHR. This enables prescribers to have more meaningful discussions with patients at the point of care, eliminate patient “sticker shock” and improve medication adherence.

To learn more about the impact Surescripts Real-Time Prescription Benefit is having on patients and providers, read the complete data brief.

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