Transparent Cost Information Positively Impacts Prescribing Trends

According to a recent study presented at AMCP Nexus 2018, providing transparent cost information to prescribers resulted in a positive impact on prescribing trends, and researchers found that prescribers were willing to make retroactive conversions when there was a clear cost benefit. 

The researchers, led by Gina DeRue, PharmD, HealthNow, and colleagues, explained that there has been a sharp increase in prescription drug spend since 2012. 

“Prescription costs for multisource brand and single source generic drugs are one driver of pharmacy expenditure for health plans,” the research team explained. “Prescribers are often ill-equipped to identify and react to high cost drugs in the absence of transparent, actionable cost information.” 

In order to reduce the prescribing trend of brand and high cost generic drugs as well as observe cost savings for health plan and members, Dr DeRue and her colleagues launched a pilot program that targeted high-cost drugs in 5 therapeutic subclasses for 3 primary care practices. The subclasses chosen for the pilot phase of the program all had a lower-cost therapeutic alternative to the target drugs. The subclasses included:

• short-acting beta agonists (SABA); 
• proton pump inhibitors (PPI);
• nasal steroids (NS);
• urinary antispasmodics (UA); and, 
• biguanides (BIG). 

For the study, the researchers indentified 2711 members using a target drug. Accoridng to the findings, 303 (11.2%) were successfully converted to a recommended drug, which resulted in $461,029.51 in savings to the health plan based on fill data. The researchers also found that the calculated member cost share savings was $22,555.81. Finally, the researchers found that the change in targeted prescribing for each subclass was:

• SABA (0.4%);
• PPI (0.8%);
• NS (-1.5%);
• UA (-2.2%); and,
• BIG (-0.2%).

“Providing transparent cost information to prescribers had a positive impact on some prescribing trends,” Dr DeRue and colleagues concluded. “Prescribers were willing to make retroactive conversions when there was a clear cost benefit to the member with no clinical barriers but were less willing to make high cost to low cost generic changes if tiers or copays did not differ.”

—Julie Gould