Practice Management

Reducing outpatient medication costs

Empowering clinicians is essential


 

For many patients, paying for medication presents a serious challenge. Studies show that up to 45% of Americans do not fill prescriptions secondary to cost, and medication nonadherence leads to morbidity and mortality, with costs from $100 billion to $300 billion annually.

One way to address the problem is by empowering clinicians to reduce patient outpatient medication costs – the goal described in a recent abstract.

Dr. Alan Kubey
Dr. Alan Kubey
The researchers partnered with GoodRx to provide prescription pricing and discount information. “We used this data to create a new proprietary algorithm-based tool to further reduce prescription cost,” wrote lead author Alan A. Kubey, MD. “Leveraging a combination of therapeutic interchange and analysis of medication dose, formulation, quantity, pharmacy, and available discounts, we are able to identify the most high-value therapeutic choice for a particular patient.”

Initial testing was promising. One patient, admitted for the fourth time in 14 months for hypertriglyceridemia-induced pancreatitis secondary to medication nonadherence, was able to reduce 90-day outpatient medication cost by 95%, from $1,287.00 to $61.79. By reducing his readmissions, the institution saved more than $20,000 a year.

The researchers secured internal grant funding to develop an automated version of the tool. “We currently have technology that can dramatically reduce the cost of many medications with early promising results for patient outcomes, readmissions rates and overall systemic cost,” Dr. Kubey said. “We are working rapidly to further develop and study our tool and, if prospective results confirm our initial findings, we will seek to provide this tool to clinicians broadly.”

Such tools are a true win-win. Hospitalists using them help ensure that discharged patients are able to afford the often life-saving medications that will keep them healthy and out of the hospital, improve readmission rates, patient satisfaction metrics, total system cost, and, most important, do right by our patients in need for whom we are charged to care, Dr. Kubey said.

“Hospitalists first must be aware that savings of 90% or more are possible for many medications and that medication nonadherence because of cost is a serious issue affecting nearly half the patients we see,” he said. “The first step is simply asking patients if medication cost is proving troublesome – we cannot address what we do not see. The second step is to use current discount tools such as GoodRx, NeedyMeds, and the like – and, we hope, in the not too distant future, our tool, which we plan to integrate into EHR prescribing to make it easy and nearly instantaneous for hospitalists to prescribe the most high-value, low-cost medication regimen for each individual patient at discharge.”

Reference

Kubey A et al. Expensive free hospitalizations – A novel approach to reducing outpatient medication cost [abstract]. J Hosp Med. 2017; 12 (suppl 2). Accessed Aug. 7, 2017.

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