Innovation fills provider data gap, enables cost-effective prescribing
Prime Therapeutics LLC (Prime) and RxRevu, the nation’s leading prescription price transparency company, are teaming up to offer Real Time Benefit Check, aka Real-Time Prescription Benefit, aiming to improve members’ health while bringing down costs and creating a more positive pharmacy experience. Real Time Benefit Check offers prescribers real-time information about available drug options, compares the exact out-of-pocket cost of each drug based on a patient’s specific pharmacy benefit plan, and flags whether a pre-authorization is needed for a selected drug. Real Time Benefit Check is embedded within the electronic prescribing function of a health care provider’s electronic health record (EHR) system.
“The integration of Prime’s member data into RxRevu’s platform gives prescribers seamless access to benefit information they can trust,” said Christine Bent, senior vice president and chief operating officer for Prime. “Real Time Benefit Check makes electronic prescribing easier, faster and more personalized. And it can lead prescribers to choose a lower-cost drug which means fewer surprises for members and lower overall health care costs.”
Prime recently completed a 14-month pilot processing 700,000 transactions among 25,000 prescribers to understand the nuances in bringing prescription coverage information to prescribers’ fingertips. Pilot results showed an average annual savings of $692 for each prescription that was changed as a result of use of the service and total estimated savings due to drug switches of nearly $350,000 for one Blue Plan. By collaborating with RxRevu, who has deployed Real Time Benefit Check across hundreds of health systems nationwide, Prime aims to continue to reduce prescribing friction and improve the member experience.
While it’s easy to make price comparisons for goods and services online, most people don’t know their prescription costs until they visit the pharmacy. Twenty-one percent of older adults don’t take their medicines as prescribed because of cost, which can lead to complications from untreated medical conditions.1 Real Time Benefit Check gives prescribers information on members’ costs before they write prescriptions by analyzing deductibles and other variables impacting out-of-pocket cost that determine what the member will pay at the pharmacy counter. When embedded into the medication ordering process, Real Time Benefit Check may increase medication adherence, which improves patients’ health and provider efficiency, and lowers costs for payers.
Under a Medicare rule, companies with prescription drug plans for seniors must offer real-time pricing information by Jan. 1, 2021. Real Time Benefit Check seeks to aid Prime’s Medicare Part D sponsors in meeting this requirement and goes a step further by applying it to commercial members.
“Prime is an important addition to the RxRevu solution, which includes the most comprehensive and accurate Real-Time Prescription Benefit network available,” said Kyle Kiser, President and Chief Strategy Officer at RxRevu. Kiser added, “We are collaborating with the Prime team to deliver our intelligent alternatives solution to ensure prescribers have the most relevant information at their fingertips. This allows for a seamless prescribing experience for the clinician and patient, limiting unnecessary administrative burden and ordering steps.”
RxRevu specializes in providing prescription price transparency to hospitals, health systems, and clinics across the country. With connections to the largest PBMs nationwide, RxRevu has the most comprehensive and accurate real-time benefit network, providing patient-specific cost and coverage information for millions of people. Since RxRevu has direct connections to PBM data sources, the information displayed at the point-of-care is both accurate and specific, allowing for reduced errors and coverage gaps in the EHR, and an improved prescribing experience. RxRevu’s primary focus is bringing unique value to patients, providers, and health systems through innovations in product functionality and support.
Select Prime Medicare and Commercial clients will implement Real Time Benefit Check this year. Prime will continue to enrich the offering and roll it out to additional Blue Plans in 2021. The collaboration with RxRevu is Prime’s latest endeavor aimed at streamlining medication prescribing and improving transparency of health care costs.
1. 2019 KFF Health Tracking Poll. Kaiser Family Foundation. Accessed July 6, 2020.