By: Kennedy Shelley
Your doctor can save you big bucks on your prescriptions. He knows just how much they cost, and if you ask, they can check it for you.
This may lead him or her to look for cheaper alternatives or prevent sticker shock for you at the pharmacy counter.
Unfortunately, many doctors have been slow to put this tool to work.
Allina Health, which is a large hospital-based network, has started putting drug price information on the physician’s screens so doctors know what it is going to cost their patients when they are in the office.
This has two effects:
- It may cause the doctor to look for low cost alternatives.
- It increases patient compliance because they know when they go to the pharmacy if they can afford the medicine.
It turns out that many patients decide at the pharmacy counter not to get a medicine because they can’t afford it, and that is the wrong place to make that call. If they can negotiate with the doctor and figure out what they can afford, the doctor may focus on the absolutely vital medication and not give the “let’s give it a try” medications.
Yes, it does provide benefit to the insurance companies too. They find their costs go down, so the more information available, the more benefits trickle down to everyone.
When patients abandon medications at the pharmacy counter, they may be costing themselves more money down the road with unexpected consequences.
But doctors have been slow to adopt these new tools. They don’t want to get bogged down in discussions over drug costs. Humana found that only 10% of the doctors in their network are using their tools.
This is where you step in.
If patients start insisting that their doctor use these tools, then they will get used to using them when they meet with you.
This doesn’t mean that it is going to work perfectly for you.
Most of the negotiations with big insurance and big pharma are often highly secretive and competitive, so getting complete information is not always possible.
So, while your insurance company may offer this service in general, Allina’s network only works for 50% of its patients, according to published reports.
So, when the tool works, it works great, but when it’s incomplete, then doctors tend not to use it which makes this tool much less effective.
Law makers are starting to take note and are asking the industry to become more price transparent.
There is competition between major drug stores, the pharmaceutical companies and the insurance industry, and no one wants to be the first to have to let their competition see their real prices because it will probably lead to lower profits.
But transparency in the market usually works best for consumers in the end, just don’t expect any radical changes any time soon.
The National Council for Prescription Drug Programs, which is a nonprofit group that is helping to set new standards for the drug industry, is helping to design a drug pricing tool which will look up drug costs regardless of the insurer.
When or if this system goes online, then expect to have new conversations with your doctor. It may no longer be “here is your prescription” but instead, “can you afford this medication?” And this will help all of us make better health decisions.
