Payers Push for Stronger Prescription Cost Control

November 11, 2016

Over the years, healthcare costs have continued to skyrocket for consumers and providers alike. It is a well-known fact that the United States spends considerably more on healthcare costs than any other country in the world.  In fact, the United States spends 50 percent more than the next-highest spender-which is about $9,086 per U.S. citizen. How can we as healthcare professionals reduce the cost for all parties involved in the healthcare system? Many thought leaders and influencers have offered cost reduction solutions, but perhaps the most obvious is through more regulated control of prescription drug costs.

Reducing the cost of prescriptions drugs is no easy feat, and will require the cooperation from insurance providers, physicians, and patients. Encouraging an increased consumption of generic or less costly brands is an essential factor in tackling the ever-growing monster known as prescriptions drug spending. The healthcare industry has sought out another approach to this dilemma in the form of physician education and prior authorization from the insurance provider prior to the order of name-brand drugs.

Providing education to physicians is an effective way to reduce the cost of prescription drug. The training provided gives clinicians the information required to make a choice between name-brand and cost-effect, generic drugs. The ideology behind this educational program is that providers will utilize this information in order to make better care choices for their patients; which therein reduces costs for healthcare providers and their patients.

Obtaining prior authorization from the insurance provider before the prescribed drug has been ordered will be a major help in regulating the price of prescription drugs. This process demands a more thoughtful drug ordering process on the physician’s end of the transaction – and the doctor may be more inclined to order the generic drug for his patient, reducing healthcare costs.

The key to fighting the ever inflating cost of prescription drugs is all members of the healthcare community working together to keep costs under control. Implementing and providing those in care delivery with prescription education, along with prior approval processes are currently the most effective methods being used to reign in control of this market.

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