Featured Health Business Daily Story, Nov. 2, 2017

UnitedHealthcare Connects Docs With Patient-Specific Drug Pricing

Reprinted from DRUG BENEFIT NEWS, biweekly news and proven cost management strategies for health plans, PBMs, pharma companies and employers. Subscribe today!

By Diana Manos, Senior Reporter
October 13, 2017Volume 18Issue 19

UnitedHealth Group’s health insurance and PBM units have teamed up with Allscripts to offer PreCheck MyScript, giving real-time patient-specific information on drug pricing at point of care. Insiders say United’s move is innovative and could launch a new trend in such capabilities if the venture goes well.

UnitedHealthcare and OptumRx say the product will give physicians what they have wanted for a long time: to help their patients, and thus health plans, save money. The insurer contends it is the first to offer the tool, which is now available to all care providers in its network. OptumRx will offer PreCheck MyScript to additional clients in early 2018, the companies said.

“With PreCheck MyScript, physician practices will spend more time with their patients and less time on administrative tasks,” said Sam Ho, M.D., chief medical officer for UnitedHealthcare, in a statement. “It takes the guesswork out of determining whether a prescription is covered by the patient’s benefit plan and if prior authorization is needed. PreCheck MyScript also improves the patient experience due to the more precise cost information that is shared before the patient leaves the doctor’s office.”

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According to the companies, doctors who prescribe using PreCheck MyScript can view real-time pricing information by pharmacy. They can also determine if a medication requires prior authorization and if it’s covered or non-preferred. The tool will also suggest alternative, lower-cost medications that may not require prior authorization, and in some instances, it can help speed up the approval process.

Nadina Rosier, Pharm.D., health and group benefits practice leader, pharmacy at Willis Towers Watson, tells AIS Health that “the product is a unique feature of UnitedHealthcare’s offering, but it is certainly not a new need, or new desire in the market.”

“This type of connectivity will likely emerge as a trend once there is market success,” Rosier says. “Others are watching closely.”

Doctors have been looking for such a product for a long time. American Medical Association President Andrew W. Gurman, M.D., a hand surgeon from Altoona, Pa., gave an example in a recent issue of the AMA Wire.

“[O]ne common generic drug, metformin, is priced wholesale for his local pharmacy. The same drug that costs the pharmacy less than 7 cents per 500 mg tablet costs more than $8 per 1,000 mg tablet,” he says.

“Your doctor writes that you need 1,000 mg of metformin, but she doesn’t know that that’s 100 times more expensive than writing two times 500 mg. We’ve got to fix this and docs can’t be the sole answer. They can’t be responsible for knowing all of the prices for all of the drugs in all of their possible combinations.”

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