Surescripts, the company that electronically connects physician offices to pharmacies for electronic prescribing and medication histories, plans to give physicians and other prescribers the ability to view a patient’s pharmacy benefit information at the point of care. Its collaborators in this service, promised to be available as early as 2018, include electronic health records (EHR) vendors Aprima, Allscripts, Cerner, Epic, GE Healthcare, and Practice Fusion, and pharmacy benefit managers (PBMs) Express Scripts and CVS Health.
When Surecripts’ “real-time prescription benefit” service goes online, Surescripts said in a news release, “prescribers will be able to see what a medication will cost their patient, based on their specific health plan coverage, and pick the most affordable medication that meets the patient’s therapeutic need.”
Physicians will be able to combine this prescription benefit service with Surescripts’ CompletEPA, the electronic prior authorization service that the company has offered since 2015. If a health plan requires prior authorization for a particular drug, in many cases prescribers who use CompletEPA can obtain it electronically before the patient leaves the office, the company said.
Besides reducing the burden on providers of manual prior authorization, this capability means that patients can go to the pharmacy knowing that the prescription has already been authorized. According to Surescripts, electronic prior authorization can reduce the number of prescriptions that are not filled because patients get tired of waiting for them to be approved.
For the electronic prescription benefit and prior authorization services to be useful to prescribers, they must be integrated into the providers’ EHR workflow. According to Surescripts, CompletEPA is available in EHRs used by 75% of US physicians and is connected to PBMs representing 85% of covered lives.
The six EHR vendors that have partnered with Surescripts in the online prescription benefit service represent 53% of the US physician base, the company said. All of them, except for Allscripts, also include CompletEPA capability in their products. CVS Health and Express Scripts together manage drug benefits for nearly two-thirds of US patients, Surescripts noted.
In a 12-month pilot of the new service, CVS and Express Scripts generated 3.75 million transactions that delivered prescription benefit information to prescribers in real time, Surescripts said.
Executives of Surescripts and the two PBMs stressed in the press release that information on drug pricing and therapeutic alternatives can help physicians choose the medication that gives the patient the biggest bang for the buck within their health plan. The ability to write cost-effective prescriptions and the assurance to patients that their health plan will cover the prescriptions, they said, should result in greater medication adherence.
“Surescripts’ real-time intelligence coupled with an automated authorization workflow will improve interactions between patients, physicians, pharmacists and benefit providers,” said Lynne Nowak, MD, vice president, Clinical and Provider Solutions at Express Scripts. “It unlocks physicians’ ability to understand — in real time — the most appropriate and cost-effective treatment options for each patient. Combined, this technology improves the prescribing experience, increases patient access to more affordable medications, drives adherence and ultimately, creates better health outcomes.”
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