May 22 2019

Talking to Patients about Generic -- and other -- Drug Price Increases

In mid-May, Connecticut Attorney General William Tong appeared on CBS’s “60 Minutes” to detail what he described as an “industry-wide conspiracy” to “fix” generic drug prices.  Tong said that he, along with a coalition of at least 40 other attorneys general had filed a lawsuit against the nation’s largest generic drug makers, who he accuses of purposely – and illegally – working to coordinate price increases.

In the course of the segment, Tong noted that he personally has been affected by the surging drug pricing crisis.  “This is my bottle of doxycycline.  It is a common antibiotic that I take every day for a skin condition,” he told CBS reporter Bill Whitaker.  “And there is a conspiracy around doxycycline.  And so, sitting here today as the attorney general of the state of Connecticut, I’m one of the victims. 

“Between 2013 and 2014,” Tong continued, “a bottle of doxycycline shot up 8,281 percent from $20 to more than $1,800.  A bottle of asthma medication, albuterol sulfate, jumped more than 4,000 percent, from $11 to $434.  Pravastatin, a cholesterol drug, up more than 500 percent, from $27 a bottle to $196.” 

Not surprisingly, the 60 Minutes interview fueled nationwide concern over this issue.  If generic drugs are supposed to be the “affordable” alternative to brand name drugs, how is it possible that prices are skyrocketing at such an shockingly fast rate?  And if generic drugs suddenly become unaffordable, what options are left for patients in need of these medications?

For pharmacists, who are often on the front lines in having to notify patients about increased drug costs, changes in drug formularies, deductibles, co-pays, prior authorizations and all other serious drug-related issues, these messages can be difficult to deliver.  That’s because pharmacists are well aware that “affordability” is a top reason for non-adherence, with a poll by Prescription Justice finding 1 in 4 Americans having to choose between their medications and other necessities such as food or housing.

How then, can a pharmacist help patients manage their medications at a time of soaring price increases?  For pharmacies with fully-integrated technology management systems in place, a few options are available:

Prescription Price Analyzer.  Certain technology systems provide a Prescription Price Analyzer, which allows quick access to competitive pricing information for a particular drug.  That pricing information can be accessed for a particular geographic region, and can also be tracked over a historical period.  Such real-time the analysis allows a pharmacy to shop around for the lowest prices, which in turn helps manage the cost charged to patients.

Payer Formulary Reviews/Pricing Analysis.  An advanced technology system will be able to integrate with third-party payers’ systems, to obtain firsthand information about drugs – and discounts – offered in a patient’s formulary.  A pharmacist can use this formulary access to potentially identify lower-cost alternative drugs with similar benefits.  In addition, a pharmacist may be able to determine if cost savings may be achieved by dispensing a 90-day supply of a particular drug, rather than a 30-day supply. 

Manufacturer Incentives/E-Coupons.  Technology can also ensure that patients are afforded all manufacturer rebates and discounts that may be associated with a particular drug.  As manufacturers have increased the use of electronic coupons in recent years, pharmacies must establish protocols for accepting, validating, redeeming and recording those transactions.  A comprehensive management system can allow pharmacies to seamlessly and efficiently manage this process while ensuring that every step of the transaction is accurately recorded. 

Identification of legislative/regulatory relief options.  Pharmacists can also tap into numerous online resources that help identify opportunities for qualified patients to receive their medications at a reduced rate.  According to Pharmacy Times, a few popular websites include:

  • NeedyMeds can help identify the manufacturer co-pay cards, prescription assistance applications, and disease-based assistance programs.
  • RxAssist provides access to a comprehensive directory of assistance programs.
  • IndiCare provides information about manufacturer-sponsored patient assistance programs.
  • Patient Access Network Foundation provides assistance based on specific diseases, with a focus on patients with cancer or rare diseases.
  • Medicine Assistance Tool (MAT) is a search engine maintained by the Pharmaceutical Research and Manufacturers of America (PhRMA) that helps identify resources available through various biopharmaceutical industry programs.
  • BenefitsCheckUp and provide information about additional support that may be available to Medicare Part D recipients.
  • Resources may be available at the state level, including North Carolina Med Assist which provides free pharmacy services to qualified Tar Heel State residents

As the national debate continues about how to address ongoing spikes in drug costs, pharmacists will continue to try and explain these seemingly unexplainable cost increases to their patients.  And while no answer will every truly be satisfactory, technology-based options can allow pharmacists to identify options for helping patients obtain their medications.