The cost of medication: A critical provider/patient dialogue

Blog Posts  |  13 August 2020  |  By Tom Pasquariello, PharmD, BCPS, BCMAS, PMSP

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

With the advent of consumer-directed healthcare, Americans are increasingly absorbing a greater cost of their healthcare. As a Pharmacist, I have witnessed firsthand the reaction of patients who are surprised to learn of the high cost of a drug when they are at the pharmacy counter. I have seen them pause and struggle to decide if they can afford to fill their prescription. With this happening in our society, it is important for physicians to not only consider their patients physical health, but also their financial health when considering treatment options. But for many physicians, talking to their patients about the cost of medications does not come naturally. Yet, it is becoming more and more of a necessity to ensure medication adherence.

Recently, we sat down with Dr Michelle Forbes, a pediatrician with MD Pediatric Associates located outside of Dallas, TX. The discussion centered on the challenges associated with the cost of prescription medications, the importance of understanding a patient’s ability to pay for the medications prescribed and how healthcare providers can work to find affordable alternatives.

Dr Pasquariello: What is the first thing you thought about when considering discussing the cost of medications with patients?
Dr Forbes: Honestly, I was a bit reluctant at first because I considered talking to patients about finances to be out of my scope. Over time, I began to find the value in price transparency as it helps me provide the right medicine at the right time at the right cost for my patients.

Dr Pasquariello: Other than your reluctance at first, what other challenges do you see that may make it difficult to have a conversation about price of medications with patients?
Dr Forbes: A few years ago, it was almost impossible for me to know what a prescription would cost. So, the patient learned of the cost of the medication at the pharmacy and often called back asking me to prescribe a less expensive option. But since I didn’t have cost information, it was very difficult to find an alternative that cost less. So that was the initial challenge that I faced.

Dr Pasquariello: And now you have access to this information?
Dr Forbes: Yes. Through a tool called Veradigm RxTruePrice™ that appears in my Electronic Health Record (EHR) when I write a prescription.

Dr Pasquariello: How are you made aware of the cost? Is the information easy to find?
Dr Forbes: It actually shows up at the point of prescribing on the same page, so it’s very convenient. As long as I have my patient’s insurance information entered correctly, it will show me their 30 and 90-day cost as well as the cash price at any pharmacy.

Dr Pasquariello: What would you say is the largest benefit you have noticed?
Dr Forbes: I used to spend numerous hours on the telephone with families who got to the pharmacy, found out the cost of the medication and called back asking for a less expensive alternative. Now I can talk to my patients about the cost of medication before they leave the office and save all that time.

Dr Pasquariello: How does this help patients?
Dr Forbes: If patients can’t afford their medication, they are not going to take it. When patients don’t take the medicine I prescribe, it can be detrimental to their health. By talking with them about the cost of medication up front, it takes the issue of affordability out of the equation. We address it head-on in the exam room.

Dr Pasquariello: How do you initiate a conversation about the cost of medications with patients?
Dr Forbes: After I enter the information into the tool, I’m able to simply turn my computer monitor and show the patient what’s on the screen. Based on their reaction we’re then able to have a conversation about cost and options. And I’m able to show them how we can use the tool together to find a more affordable option, if they need one.

Dr Pasquariello: Do you feel having a conversation about the cost of medications helps you build a stronger relationship with patients?
Dr Forbes: It certainly strengthens the relationship, yes. I believe patients feel that I am as invested in their care and their financial wellbeing as they are.

Dr Pasquariello: Final thoughts Dr Forbes….
Dr Forbes: Talking about the cost of medications as part of the in-office patient experience has made life easier for me, but more importantly made life simpler for my patients who know what their medication will cost before they leave the office. I truly love when I get that “wow” factor from my patients when they realize I have access to the pricing information at my fingertips, it makes me smile!

About Veradigm RxTruePrice™

Veradigm RxTruePrice™ is a prescription price transparency solution that delivers patient-specific discounted pharmacy benefit pricing including cash, therapeutic alternatives and competitive prices at local pharmacies directly into each prescriber’s clinical workflow. It is a fundamental component of Veradigm’s electronic prescribing platform, Veradigm ePrescribe.

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