Jen Radueg had been taking Advair for her asthma for over 15 years when the price under her insurance plan skyrocketed from $60 to $300 this year. She paid the higher charge and tried to reduce her inhaler use to save money, but wasn't happy with the results.
Radueg, a Denver event producer who has had similar issues with her EpiPen prescription, luckily had a sympathetic doctor who was able to find her a alternative, Symbicort, for only $25 per inhaler. But she said she'd prefer some advance warning of how much drugs will cost so she isn't scrambling to obtain vital medications.
“As a consumer, to be able to know what you're getting and why, to shop around on the spot, that would be ideal,” Radueg said. “No one wants to just get that (surprise) bill.”
For many patients such as Radueg, especially those with high-deductible insurance plans, the price of filling a prescription is largely unknown until they get to the pharmacy. That can leave some patients shocked at the register, sometimes unable or unwilling to pay. That's not good for patients or for healthcare. When people don't take their drugs or take less than the prescribed dose, the result can be disastrous.
Patients aren't the only ones in the dark about drug prices. Doctors are largely unaware of copays although they may have an idea of the cash price. But variation in insurance coverage is far too wide for them to have reliable, accurate information for each patient, experts say.
A number of insurers, pharmacy benefit managers and technology companies are developing smartphone and computer apps to provide that information for patients and physicians. They provide coverage information before patients reach the pharmacy, inform patients where their prescription can be filled at the lowest cost, and offer alternatives that may be cheaper.
The goal is to cut down on cost-driven noncompliance.
According to the 2013 National Health Interview Survey by the U.S. Centers for Disease Control and Prevention, to save money nearly 7.8% of U.S. adults did not take their medication as prescribed, 15.1% of respondents asked their doctor for a lower-cost medication, 4.2% chose to use an alternative therapy and 1.6% bought the prescriptions abroad.
A 2015 Kaiser Family Foundation study found that 24% patients reported not filling a prescription in the past year because of cost. Nineteen percent reported cutting pills in half or skipping a dose because of cost.
The apps, which offer patients cost information, can save time and prevent uncomfortable interactions at physician offices and pharmacies. Clinicians often spend a significant amount of time discussing insurance coverage and changing their patients' prescriptions.