Prescription Price Transparency

Prescription Price Transparency

Prescription pricing in the United States varies greatly and is extraordinarily difficult to predict. One thing we all understand, however, is that prescription drugs can be costly. The average American spends around $1,200/year on medications.1 The ability for families to afford health care has increased from an area of high concern in the 1990s to an area of extreme anxiety for millions of Americans today. According to Gallup, when surveyed, 27% of individuals in the U.S. identified either healthcare or medication affordability as the country’s “most urgent health problem.”2

Part of the anxiety associated with medication affordability stems from the unpredictable nature of insurance reimbursement for prescriptions. Unlike many consumer goods, the out-of-pocket costs patients pay for their prescriptions can vary significantly and often depends upon insurance coverage, where they live, which pharmacy they visit, and whether they have any coupons or discounts available to them.

Addressing medication affordability through prescription price transparency is a key focus area for Veradigm. We’ve compiled this guide to prescription price transparency with links to related blog articles, reports, videos, and more.

Why Prescription Drug Price Transparency Matters

Prescription drug price transparency matters because many patients live on a budget, and factoring in the cost of medications is critical. Research shows that 42% of Americans have reported they are struggling to pay for their prescribed medications.3

Unfortunately, prescription drug pricing can be complicated and the prices themselves are variable. Patients, therefore, are often left in the dark about how much their medication will cost when they arrive at the pharmacy.

Healthcare providers are also typically unaware of the cost associated with the medications they prescribe. If clinicians are empowered to have a conversation about the cost of prescriptions at the point-of-care, they can work together with patients to choose the most cost-effective, clinically appropriate option for their treatment.

Patients are Consumers Too

Patients are empowering themselves to play a more active role in the management of their health. With the rise of e-commerce and online price comparison tools, we all have become accustomed to being able to compare prices when shopping. Why should prescription medications be any different?

Physicians are trained to prescribe medications based upon a variety of factors other than affordability. Medications are selected based upon clinical guideline recommendations, patients’ diagnoses and co-morbidities, drug interactions, tolerability, and other clinical factors. By recognizing that patients are consumers too, prescribers can begin to leverage price transparency tools to have a cost conversation with their patients at the point of care.

Trust Through Transparency

Having a transparent price conversation at the point-of-care can increase trust between clinicians and their patients. Knowing how much a prescribed medication will cost reduces sticker-shock when patients arrive at the pharmacy to pick up their prescription. No one likes to be surprised with a big bill they were not expecting, especially when it has to do with something as important as healthcare.

If a patient and prescriber select medications together, while incorporating price into the conversation, a level of trust is established between the two parties. When a patient arrives at the pharmacy to pick up the selected medications, and there are no surprises when it comes to cost, that trust is reinforced.

Medication Adherence

Perhaps the most important reason why prescription drug price transparency matters is medication adherence. Medications can only improve health outcomes if patients take them as directed. Patients can only take their medications as directed if they can afford them.

Research shows that higher out-of-pocket costs for prescription medications correlate with increased prescription abandonment. In fact, 33% of patients have purposely failed to fill a prescription due to prohibitive cost. What’s more, nearly 6% of patients have skipped doses of their medications three times or more to save on drug costs.3

Having the Pricing Discussion at the Point-of-Care

While many prescribers are aware that discussing price with their patients is an option, initiating the conversation can be difficult. A survey conducted by Veradigm in 2019 found that some physician respondents reported that they did not view the medication cost conversation as their responsibility. Others said that while they understood that patients valued the conversation, they did not feel comfortable or equipped to have it.4

The tendency to shy away from a potentially uncomfortable conversation about financial matters is understandable. With easy-to-use technology integrated into a prescriber’s workflow, however, it requires little to no additional effort to access patient-specific prescription medication pricing at the point-of-care. In fact, failing to discuss prescription pricing with patients represents a missed opportunity to improve standards of care.

While it may seem daunting at first, discussing medication affordability relevant to patient care quickly becomes easier with experience. And with technology at prescribers’ fingertips, clinicians can initiate the conversation by simply showing their patient a screen with available options.

How Can Patients Save Money on Prescription Drugs?

Patients can save money on prescription drugs in a variety of ways. Prescription drug pricing is highly variable depending on a patient’s insurance, their geography, if a generic version of the medication is available, which pharmacy they select to fill their prescriptions, or if they make use of price comparison tools like GoodRx®.

One extraordinarily powerful way for prescribers to help patients save money on prescription drugs is to use a prescription price transparency tool integrated directly into their electronic health record.

In the next section, learn about how Veradigm RxTruePrice™ is helping patients save money on prescription drugs.

Prescription Price Transparency and Veradigm RxTruePrice

Veradigm RxTruePrice empowers prescribers to enhance medication affordability for patients with a prescription price transparency solution integrated directly into the e-prescribing workflow. This powerful solution from Veradigm simplifies electronic data exchange on medication cash price, benefit coverage, potential alternate therapies, mail order options, prior authorization requirements, quantity or days’ supply coverage limitations, and more.

RxTruePrice helps to identify appropriate cost-saving opportunities, reduce medication wait time, and decrease the interruptions in patient care that can occur between the physician’s office and picking up or receiving prescribed medications. RxTruePrice also reduces rework for the healthcare provider and staff and can eliminate unnecessary calls from pharmacies due to challenges with affordability.

In 2019, Veradigm surveyed users of RxTruePrice. The results demonstrated that RxTruePrice is helping healthcare providers positively drive improvement for patients.

60% of respondents observed an overall improvement

in patient adherence to prescribed medications included in their care plan with Veradigm RxTruePrice4

More than 50% of respondents

said Veradigm RxTruePrice has helped them reduce the amount of communication required between pharmacies and practices5

85% of HCP respondents believe

the ability to provide pricing and insurance information positively impacts patient satisfaction with their practice5

Explore Related Insights on Prescription Price Transparency

Reduce Medication Non-Adherence and Improve Prescription Affordability with eCoupons

Learn how eCoupons can help patients save money on their prescription medications and improve their ability to adhere to their prescribed treatment regimen.

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Podcast: How Electronic Prescriptions Can Help Optimize Patient Care

Listen to a discussion on the Dental Deep Dive podcast on how electronic prescriptions can help optimize patient care with ePrescribe Solutions.

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Price Transparency and Prescription Affordability: A Conversation with MGMA

Veradigm participated in a conversation hosted by MGMA on prescription price transparency and how to facilitate the medication cost conversation with patients.

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The Medication Cost Conversation – What’s the Hold-Up?

Pediatrician Dr Michelle Forbes, M.D. will join other clinical peers for a conversation on how to effectively approach medication cost conversations with patients in the era of prescription price transparency.

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The cost of medication: A critical provider/patient dialogue

A discussion with Pharmacist Dr. Tom Pasquariello, PharmD and Pediatrician Dr Michelle Forbes, M.D.

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EHR Tools Can Help Increase Medication Prescription Fill

One of the great EHR tools available to help patients save money on their medications is RxTruePrice, a tool that helps clinicians find cost-effective options.

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Starting the Rx Cost Conversation with Patients – A Guide to Getting Started

With price transparency solutions like TruePriceRx, many physicians have found effective ways to start the Rx Cost Conversation with their patients.

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Veradigm RxTruePrice™ Makes a Difference for Patients

Find out how Veradigm TruePriceRx is impacting clinician time, staff and patient satisfaction, and medication adherence for a Dallas-area Practice.

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Observed Impact of Veradigm RxTruePrice on Provider Medication Adherence

The root of a patient’s failure to adhere to their prescribed medication care plan is often related to their ability to afford the financial cost of their medication.

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Prices for Prescription Medications Vary Widely Depending on Where a Patient Lives – What Can Be Done About it?

Medication prices can significantly vary from pharmacy to pharmacy, as well as by geography.

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Veradigm’s Jill Helm Talks Medication Affordability with Specialty Pharmacy Continuum at Asembia Specialty Pharmacy Summit 2019

Jill Helm Talks Medication Affordability with Specialty Pharmacy Continuum at Asembia Specialty Pharmacy Summit 2019.

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A Look at Price Transparency Through the Patient’s Eyes

Solutions like Veradigm’s Price Transparency make now an ideal time for patients to make a more conscious effort to take charge of their healthcare.

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A Look at Price Transparency Through a Clinician’s Eyes

A clinician's perspective on how to address medication affordability through price transparency.

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Veradigm RxTruePrice™ Users See Positive Impact on Medication Affordability

Addressing medication affordability through the Veradigm RxTruePrice™ prescription price transparency solution is an example of how Veradigm is working to make this transformation a reality.

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Veradigm™ partners with Surescripts for a conversation on price transparency at HIMSS19.

Veradigm™ partners with Surescripts for a conversation on price transparency at HIMSS19. Watch video highlights from panel discussion.

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Patient Visibility into Out-of-Pocket Prescription Costs Takes on Added Importance in January

Between pending federal legislation on price transparency and the rising tide of patient self-empowerment, there has never been more focus on closing the gap between patients’ prescription out-of-pocket (OOP) costs and what they can afford to pay.

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  1. Quick Take: Drug Prices. Published 2020. Accessed December 2, 2020.
  2. Gallup Inc. Healthcare system. Accessed November 10, 2020.
  3. Hamm, N. Managed Healthcare Executive. How High Drug Prices Affect Patients. May 2019. Available at Accessed November 10, 2020.
  4. Results of Veradigm ePrescribe user survey conducted September 2019. Data on File.
  5. Results of Veradigm ePrescribe user survey conducted January 2019. Data on File.

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