3 Points where patients need help with their medication

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A common teaching in journalism suggests a news story is only as good as the quality of its sources. As in journalism, health care depends on information from quality sources delivered in a timely manner. Though we may have industry terms for this, like interoperability and data fluidity, and our sources may be patients, payers, pharma, pharmacists and providers, the principles are similar.

Studies consistently show patients’ health outcomes are connected to their ability to access, afford and adhere to their medications. So, it’s vitally important to get quality information into the right hands in real time. For example, pharmacy-specific medication pricing and patient-specific benefit information can help facilitate faster medication access, unlock broader affordability options and provide information patients need to adhere to therapy.

Our latest surveys of pharmacists, patients and providers to inform the upcoming 2023 Medication Access Report, support this. The surveys found that patients and care teams need faster medication access, greater affordability options and improved visibility at three critical junctions: the provider office, pharmacy counter and via tools patients can access directly.

Though patients are increasingly more involved in their own health care, including proactively seeking affordability options, too often they’re in the dark, without essential information when they need it most. For example, we learned in our latest poll of patients that 60% went to pick up their prescription at the pharmacy counter and found it cost more than expected. As a result, 24% of those patients left without their prescription.

In situations like that, what patients don’t know, can hurt them, but research also shows that even when patients are told this information, it’s not always enough. Half or more of the information discussed during a provider encounter is forgotten by the patient, with recall ability affected by education level, age and number of instructions given.

But having accessible data about prescription cost and medication information to support adherence in patient-facing technology could help supplement discussions that occur during an appointment. Stakeholders such as payers and pharma companies could build better relationships with providers and patients by leaning into transparent, easily accessible data exchanges. This can then allow providers to share information that helps support improved outcomes in a way patients consume it best — via apps, portals, printed discharge notes or follow-up phone calls.

When affordability options and other critical medication information can be presented across a multitude of critical touchpoints in a patient’s health journey, a safety net is thus created. When one option is unsuccessful, another awaits.

At the point of prescribing, for instance, most providers are talking to their patients about affordability options. In the last year, our latest provider survey found, 51% spoke to their patients about affordability solutions — a 9-percentage point increase over the previous year. But only a quarter said they had easy access to patent-deductible information in their EHR, limiting the impact of such conversations.

Pharmacists experience similar challenges at the pharmacy counter. In our latest pharmacist survey, 58% said they help patients with benefit information at least once a day, but 46% can’t access that information in their pharmacy systems. At similar rates, pharmacists said they’re unable to surface other important information, too — such as cash-price options, formulary alternatives or pharma-sponsored discount cards.

In other words, the answer is not found in getting better sources, but in unlocking the data that already exists — for pharmacists, patients and providers. With improved transparency and data sharing among all three groups, a three-legged approach emerges — one steadier, sturdier and better suited to weather coming disruptions.

The COVID-19 pandemic isn’t impacting health care like it was at its peak of infections, but it still lingers. So do inflation and other economic pressures, which patients we surveyed stated is among their biggest concerns for 2023. Our “new normal” is ever-changing, in other words, and though we can’t predict the future, we can prepare for what patients and their care teams may face next. Because no matter what’s on the horizon, better data access and data interoperability will be critical.

We know that patients are increasingly growing empowered as health care consumers, while trends like hybrid care models and new prescription affordability solutions continue to sprout to support an increasingly empowered patient population.

These are all positive moves in the right direction of supporting patients. But as we make our way forward with shiny new solutions and care delivery models, let’s not lose sight of our sources and how to get the rich data they’re already providing us, into the hands of those who need it most, when they need it most.

H. John Beardsley is senior vice president of corporate strategy at CoverMyMeds. In this role, John is responsible for analyzing market trends, connecting customers to new CoverMyMeds innovations and investigating potential partnerships that can yield greater value for customers and patients. John has more than 20 years of experience in health insurance, pharmacy, financial services, and health care technology.