The tool — expected to eliminate dispensing delays and lower costs for members and payers — will give healthcare providers and PBM members access to plan-specific, real-time information about medication costs, lower-cost options and out-of-pocket costs at the point of prescribing and at the pharmacy.
The tool provides visibility so prescribers can see the cost based on a patient’s coverage, including the patient’s remaining deductible, and will provide therapeutically equivalent generic medications as alternatives.
“Patients often do not find out that the medication they were prescribed is not covered or has higher than expected out-of-pocket costs until they go to the pharmacy to pick up their prescription, which can result in patients not filling a prescription, non-adherence and, ultimately, higher downstream health care costs,” said Troyen Brennan, MD, executive vice president and CMO of CVS Health. “Making detailed, real-time benefit information available for our PBM members and their healthcare team, whether it’s the doctor or the pharmacist, can help streamline the patient experience and improve health outcomes while also lowering costs for both the patient and the [payer].”
The “real-time benefits” tool is available to any provider using an EHR enabled with real-time benefits and electronic prior authorization.
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