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. 2024 Jun 5:14:100460.
doi: 10.1016/j.rcsop.2024.100460. eCollection 2024 Jun.

Assessment of the utilization of real-time prescription benefits for patient cost savings within an outpatient setting

Rachel Reise  1   2 , Asinamai M Ndai  1   2 , Marvin A Dewar  2   3 , Anzeela M Schentrup  2 , Julia Yang  1 , Scott Martin Vouri  1   2
Affiliations

Assessment of the utilization of real-time prescription benefits for patient cost savings within an outpatient setting

Rachel Reise et al. Explor Res Clin Soc Pharm. .

Abstract

Background: This study evaluates the impact of Real-Time Prescription Benefits (RTPB), a tool integrated into electronic health records (EHRs), on patient out-of-pocket costs in an academic institution. RTPB provides prescribers with alternative, less expensive medications based on insurance plans. The primary measure was cost-savings, defined as the difference between the out-of-pocket cost of the prescribed medication and its alternative.

Methods: A retrospective analysis of prescriptions from outpatient clinics in a university-based health system was conducted between May 2020 and July 2021. Prescriptions were analyzed at the 2nd level of the Anatomical Therapeutic Chemical (ATC) classification system. Costs were standardized to a 30-day supply. Standardized cost and total cost per prescription, and overall savings for the top 20 medication classes at the 2nd ATC level were calculated. The overall impact of RTPB was estimated based on selecting the least expensive alternative suggested by RTPB.

Results: The study found that RTPB information was provided for 22% of prescriptions, with suggested alternatives for 1.26%. Among prescriptions with an alternative selected, the standardized average cost saving was $38.83. The study realized $15,416 in patient total cost savings. If the least expensive RTPB-suggested alternative were chosen for all prescriptions, an estimated $276,386 could have been saved. Psychoanaleptic and psycholeptic medications were the most prescribed with an alternative, with most savings in specialty drugs like anthelmintic and immunostimulant medications.

Conclusion: The study highlights the importance of RTPB in reducing patient costs. It reports patient cost-savings with RTPB in prescribing decisions. Future research could explore the impact of RTPB on medication adherence using pharmacy claims data.

Keywords: Cost savings; Electronic health record tools; Out-of-pocket costs; Prescribing; Prescribing practices; Real time prescription benefits.

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Conflict of interest statement

Scott Martin Vouri is a current employee at Pfizer, Inc., but was previously employed by the UF College of Pharmacy for the duration of this project. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow diagram for inclusion and exclusion criteria.
Fig. 2
Fig. 2
Distribution of the total number of prescriptions by specialty (n = 19,973 Rxs).
Fig. 3
Fig. 3
Average copayment per prescription for those who accepted suggested alternative (n = 473 Rxs).
See this image and copyright information in PMC

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