{"id":19960,"date":"2018-03-01T08:00:37","date_gmt":"2018-03-01T13:00:37","guid":{"rendered":"http:\/\/www.carecloud.com\/continuum\/?p=19960"},"modified":"2025-06-25T15:23:57","modified_gmt":"2025-06-25T15:23:57","slug":"can-physicians-benefit-from-reducing-patient-prescription-costs","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/can-physicians-benefit-from-reducing-patient-prescription-costs\/","title":{"rendered":"Can Physicians Benefit From Reducing Patient Prescription Costs?"},"content":{"rendered":"

by Emily Peters<\/i><\/p>\n

Talking about money has long been considered taboo in medicine, but your patients\u2019 perspective has changed. A 2017 study found that 70 percent of patients now think it\u2019s a good idea for doctors and medical practices to discuss prices, but less than a third report price being mentioned in their visits.<\/p>\n

In the past 10 years, insurance companies have passed 25\u201380 percent more of prescription costs on to patients. Nearly half of Americans are having trouble paying for the prescriptions they require. The high cost of medications is cited as the top reason for patients\u2019 nonadherence, and a full 30 percent of prescriptions are never filled at all (according to an NCBI study). This financial challenge for patients is directly tied to medical practice outcomes and satisfaction.<\/p>\n

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\n\u201cThe high cost of medications is cited as the top reason for patients\u2019 nonadherence, and a full 30 percent of prescriptions are never filled at all.\u201d<\/span><\/h2>\n<\/blockquote>\n

To discuss, we sat down with Jordan Michaels, the director of operations at GoodRx<\/a>. The company tracks medication pricing across more than 75,000 pharmacies, helping patients cut over $3 billion in prescription costs since 2011. Michaels started out his career thinking he\u2019d become a physician, but he quickly realized a passion for health technology. He founded a startup called Ringadoc providing an after-hours telemedicine answering service, before moving into the electronic health records space and then to GoodRx.<\/p>\n

Emily Peters (EP): <\/span><\/strong>Why do you think medical practices have avoided talking about money with their patients?<\/p>\n

 <\/p>\n

Jordan Michaels (JM): <\/span><\/strong>In my experience, doctors are stretched across demanding patient schedules and managing their medical practices, so if they could avoid the conversation about money with patients, they would, mostly because you don\u2019t want to be asked questions that you don\u2019t have the answers to. Doctors didn\u2019t have the information about patient costs.<\/p>\n

EP: <\/span><\/strong>Now, patient out-of-pocket costs are on the rise. Patients are paying for more of their medical costs directly. There\u2019s added pressure to change that conversation.<\/p>\n

JM: <\/span><\/strong>That\u2019s one of the reasons why we\u2019ve seen so much interest from medical practices. The flat $10 copay is going away. We\u2019re seeing more people in high-deductible plans. We\u2019re seeing co-insurance play more of a role in prescription drug benefits. That requires patients to be more knowledgeable and have that information about how and where to shop for their prescriptions.<\/p>\n

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\n\u201cThe flat $10 copay is going away. We\u2019re seeing more people in high-deductible plans. We\u2019re seeing co-insurance play more of a role in prescription drug benefits. That requires patients to be more knowledgeable and have that information about how and where to shop for their prescriptions.\u201d <\/span><\/h2>\n<\/blockquote>\n

EP: <\/span><\/strong>I can see why patients would want this information on drug costs and prescription savings, but why does it matter to medical practices?<\/p>\n

JM: <\/span><\/strong>My career in technology has been focused on working with doctors and trying to help make their lives easier and better so that they can save time and money while improving care. I\u2019m seeing that doctors are having to be a part of that conversation around costs now for a couple reasons. First is adherence. If your patient can\u2019t fill their medication, they\u2019re not able to follow your recommended treatment, which will ultimately worsen their condition\u2014not only a bad outcome for that individual patient, but also bad outcomes across your medical practice in a value-based care world.<\/p>\n

Patient experience is the second key reason. Data shows 30 percent of prescriptions go completely unfilled, so that\u2019s just inefficient. It\u2019s a $300 billion problem in U.S. healthcare. It\u2019s not what you want for your patients. We\u2019ve heard from doctors that patients come back to them dissatisfied when they\u2019re given a prescription that they just can\u2019t afford. They\u2019re somewhat uncomfortable because the solution is in front of them that this medication would help with their health condition, but they simply can\u2019t afford it.<\/p>\n

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\n\u201cData shows 30 percent of prescriptions go completely unfilled, so that\u2019s just inefficient. It\u2019s a $300 billion problem in U.S. healthcare. It\u2019s not what you want for your patients.\u201d <\/span><\/h2>\n<\/blockquote>\n

And a third big reason is time-savings for the medical practice. A dermatology practice wrote a study for JAAD about this, saying that they were able to avoid hiring one less office staff member and that the physician saved one to two hours of time each week by reducing calls from patients about medication costs. Along with a physician mobile app, we also integrate with several different electronic health record systems to present the latest drug price information right at the point of care, so patients and doctors can have that conversation. The patient can leave feeling empowered and knowledgeable on the best way to get the medication\u2014whether that\u2019s through a coupon, prescription savings from a retailer or manufacturer program, or copay assistance\u2014which ultimately leads to improved adherence and health outcomes.<\/p>\n

EP: <\/span><\/strong>Shouldn\u2019t this all be easier? Why is it so hard to get a clear picture of prescription drug prices?<\/p>\n

JM: <\/span><\/strong>Most people don\u2019t even realize that prices are different at different pharmacies. The cost of the same prescription can differ by more than $100 between two pharmacies that are across the street from each other. There are also huge savings, up to 80 percent, in switching to a generic instead of branded medication. We see the average patient saving $276 a year on their prescription by having access to price options.<\/p>\n

Pharmacy benefit managers (PBMs) cut deals with pharmacies to give insured patients a discount off the \u201csticker price\u201d of a drug. This discount can be huge\u2014a drug with a retail price of $150 can be reduced to a $10 copay\u2014and it can vary depending on where the patient buys and how many membership discounts or other coupons are available. We gather data from 70,000 pharmacies and even collect Medicare prices to try to provide the best deals.<\/p>\n

Drug prices are so complicated because there are so many different prices that a patient might receive at the counter. You might or might not have a copay based on your current coverage, but plans have different formularies, and there may be coverage restrictions. Even if you know how much insurance will pay, there might also be a lower cash price, discount price, or membership price. There\u2019s no simple formula or explanation for how prescriptions are priced; we have billions of prices in our database. To expect a patient or physician to know about all of these prices is unrealistic.<\/p>\n

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\n\u201cTo expect a patient or physician to know about all of these prices is unrealistic.\u201d <\/span><\/h2>\n<\/blockquote>\n

EP: <\/span><\/strong>That data on prescription drug prices seems like it would give you an interesting perspective on changes and trends in healthcare.<\/p>\n

JM: <\/span><\/strong>Millions of people visit GoodRx each month, so we\u2019ve developed a pretty good understanding of drug affordability and adherence. At a particular price point, are your patients more adherent? Are they more likely to take the medication? Are they more likely to purchase; are they less likely? That\u2019s the flywheel we\u2019re building, and we think that will be helpful to medical practices that are becoming aware of where and how their patients are spending.<\/p>\n

EP: <\/span><\/strong>How does it work for clinics to bring medication pricing information into practice for their patients?<\/p>\n

JM: <\/span><\/strong>We are basically building a free prescription savings adherence tool for medical practices. We see that they want to get involved in helping patients understand their cost and to make sure that they can actually get their medications. Practices can start by just knowing that services like GoodRx are out there and talking to patients about medication costs. From there, we offer mobile apps, integration in various EHRs, and printed materials for the practice including brochures and even counter cards for the waiting room.<\/p>\n

Another important service we offer is our support. We have a team of real people who help patients find the lowest prices for their medication and help them actually fill their prescription in the pharmacy. So if you can\u2019t access the mobile app, the website, or just have questions about our services or a particular prescription, we\u2019re here to help. We also have all the information on our website of what to expect when a patient is taking a new medication. It\u2019s a lot of patient services and support that a physician can offer for free. It\u2019s a big value-add for a practice and a big reason why we\u2019re working with about 200,000 practices today.<\/p>\n

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\n\u201cWe have a team of real people who help patients find the lowest prices for their medication and help them actually fill their prescription in the pharmacy. So if you can\u2019t access the mobile app, the website, or just have questions about our services or a particular prescription, we\u2019re here to help.\u201d <\/span><\/h2>\n<\/blockquote>\n

EP: <\/span><\/strong>It seems to me that this is a way for medical practices to evolve that close relationship between physician and patient. It used to be that patients would just trust their doctor and insurance company to give them good recommendations. That\u2019s more complicated now, but by bringing cost into the exam room, the doctor can continue being a trusted advisor to the patient.<\/p>\n

JM: <\/span><\/strong>There\u2019s a growing focus on social determinants of health in this country. If your patient is underinsured or can\u2019t afford healthy food, heat in their apartment, or their medications, it maybe doesn\u2019t matter how talented and expert a medical practice you are. The outcomes are going to suffer. Value-based care is one force for change. It\u2019s really up to individual medical practices to think about how they can innovate and think creatively about helping their patients. It\u2019s good to see conversations around patient cost becoming part of that transformation.<\/p>\n","protected":false},"excerpt":{"rendered":"

by Emily Peters Talking about money has long been considered taboo in medicine, but your patients\u2019 perspective has changed. A 2017 study found that 70 percent of patients now think it\u2019s a good idea for doctors and medical practices to discuss prices, but less than a third report price being mentioned in their visits. In […]<\/p>\n","protected":false},"author":1,"featured_media":32088,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[],"class_list":["post-19960","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patients"],"yoast_head":"\nPhysician Benefits from Reducing Patient Prescription Costs<\/title>\n<meta name=\"description\" content=\"Jordan Michaels, healthcare entrepreneur, talks about money, drugs, medical practice and whether or not physicians can benefit from reduced prescription costs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/carecloud.com\/continuum\/can-physicians-benefit-from-reducing-patient-prescription-costs\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" 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