Dean Riggott Photography
Surescripts
The Surescripts Network Alliance® is experiencing one of its fastest health information technology adoption curves to date as it transforms the prescription decision process, with a fortyfold increase in the number of prescribers utilizing its Real-Time Prescription Benefit tool since it launched last year. To date, prescribers have used the tool 30 million times to view patient-specific prescription price and therapeutic alternative information, integrated with their electronic health record (EHR) software, at the point of care.
EHR vendors representing 77 percent of the market have already signed on, including Allscripts, Aprima Medical Software, Cerner, eClinicalWorks, Epic, Modernizing Medicine and NextGen Healthcare. Surescripts Real-Time Prescription Benefit gives prescribers access to patient-specific and formulary-based benefit and cost information for 70 percent of U.S. covered lives and growing. This information is provided directly by leading pharmacy benefit managers (PBMs) and health plans, including CVS Health, DST (recently acquired by SS&C Technologies), Express Scripts and Navitus Health Solutions.
“Our differentiated Real-Time Prescription Benefit solution, combined with Electronic Prior Authorization and E-Prescribing, is designed to deliver patient-specific, accurate and formulary-based price and therapeutic alternative information at the point of care while protecting prescriber and patient choice,” said Tom Skelton, Chief Executive Officer of Surescripts. “Together with our partners, the Surescripts Network Alliance has achieved a breakthrough in prescription price transparency that benefits patients and providers with greater efficiency, reduced costs, and increased satisfaction.”
CVS Health recently reported that its PBM members are saving an average of $130 per prescription fill when prescribers use Real-Time Prescription Benefit information and switch to a lower-cost therapeutic alternative. According to CVS Health, prescribers using Real-Time Prescription Benefit are switching to a covered drug 75 percent of the time when the originally-prescribed drug is not on the member's formulary. In instances where the original drug is covered, but a lower-cost clinically appropriate brand or generic alternative is available, prescribers are switching patients to a lower-cost alternative 40 percent of the time.
“Realizing the potential to make medications more affordable for members, we are now offering Real-Time Prescription Benefit to all of our clients,” said Alan Van Amber, Vice President of Provider Services for Navitus. “We’re pleased that this solution will provide greater transparency when it comes to prescription costs and empower providers and members to make more cost-effective decisions.”
According to the Centers for Medicare and Medicaid Services (CMS), national health expenditure growth is expected to average 5.5 percent annually between 2017 and 2026, while prescription spending growth is projected to average 6.3 percent. Meanwhile, a $10 increase in copay raises the likelihood of prescription abandonment by 10 percent, and 40 percent of patients abandon treatment due to prescription fill delays associated with the manual prior authorization process.
“At Express Scripts, it is our long-standing mission to make healthcare less costly and less complicated for our plans and members. Access to real-time information that can direct patients to the most clinically appropriate and cost-effective therapy, delivered conveniently and at the most important points in their care continuum, activates their best intentions and leads to better health outcomes,” said Lynne Nowak, M.D., Chief Physician Experience Officer at Express Scripts. “Both Real-Time Prescription Benefit and Electronic Prior Authorization – which is 11 times faster than traditional prior authorization processes and returns decisions in under two minutes – are a win for physicians, payers and patients.”
Real-Time Prescription Benefit enables clinicians to quickly see if a prior authorization is required and view therapeutic alternatives, including those that don’t require a prior authorization—all within their EHR workflow. When used together, Surescripts Real-Time Prescription Benefit, Electronic Prior Authorization and E-Prescribing create the ideal prescribing scenario and simplify every prescription decision for every patient, every time.