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October 25, 2019

Real-Time Benefit Tools for Drug Prices

Author Affiliations
  • 1School of Medicine, Department of Health Policy, Vanderbilt University, Nashville, Tennessee
  • 2School of Medicine, Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee
JAMA. 2019;322(24):2383-2384. doi:10.1001/jama.2019.16434

Concerns over drug prices and medication nonadherence have led to a search for new strategies to lower health care costs and out-of-pocket spending by patients.1 One potentially powerful strategy is to present physicians with the price of medications and their alternatives before or during ordering. Real-time benefit tools (RTBTs) are intended to provide this information by drawing on information from pharmacy benefit plans and displaying patient-specific price information to clinicians at the time a prescription is written. Adoption and use of such technologies has been limited to date but will likely increase, as the Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that Medicare Part D plan sponsors implement 1 or more RTBTs capable of integrating with at least 1 prescriber’s electronic prescribing system or electronic health record (EHR) by January 1, 2021.2

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    2 Comments for this article
    Drug Pricing
    Karl Stecher, M.D. | Retired Neurosurgeon
    Yes, this article is helpful in explaining the intricacies of drug pricing, and what physicians must wade through when trying to spend their time treating/helping patients.

    Thanks to the authors for pointing out what physicians have known since even before it was implemented, that EHRs are burdensome and time-wasting, mandated by government non physicians.

    But the main killer re. drug prices is the ability of lawyers and patients to sue for absurd amounts of money, millions, or even billions, of dollars. A cap is needed, such as that which has stopped runaway juries (and big paydays
    for lawyers) in such states as California and Colorado as physicians risk daily the threat of "malpractice"
    Nothing Will Bring Down Drug and Insurance Premium Costs Until Medicare can Negotiate Drug Prices. Competition is key.
    Peter Kurzweil, MD, FACP, Internal Medicine | St Francis Hospital, Roslyn, NY
    The only regulation that will reduce drug prices and therefore insurance premiums is to allow Medicare to negotiate drug prices and every other aspect of medical care, such as medical devices. This was what the ACA was to include, however it failed because the drug lobby was so strong (I believe led by the senator from New Jersey, where most pharmaceutical companies are based). Healthcare economy no longer has anything to do with a free market system, the hallmark of a capitalistic society. It is run by big-business, monopolistic, monolithic behemoths, specifically pharmaceutical companies, large hospital systems and large insurance companies, and will be even more so when one company owns 1 or 2 of the other companies (such as CVS). If the 55 million 'covered lives' negotiate for each drug, competition will dramatically lower the cost of every drug. (1/3 of those lives are run by commercial plans known as Medicare 'Advantage' Plans, and this number will dramatically increase because of powerful marketing). Traditional Medicare-for-all is, in fact, rapidly headed for Medicare for none. Making meaningful change in America's health care delivery system will take overcoming the powerful lobbies mentioned above. Getting AK15's off the streets of America will be a walk in the park compared with dealing with those lobbies. It's time to return to small business as the backbone of the American economy.