When it comes to the treatment of tricky health conditions with specialty medications – such as Humira or Enbrel for rheumatoid arthritis, Vivitrol for alcohol dependence, or medications to treat hepatitis C – patients are more likely to start treatment if their prescribing physician doesn’t hand over a paper prescription.
How so? There are three key problems which can block the path between diagnosis and starting a treatment plan:
- First up: the problem of patients who simply don’t get around to turning in their prescription to a pharmacy. It’s a counter-intuitive, but well-documented, problem.
- Next, there are patients who do turn in the paper prescription (or the prescriber has phoned in or faxed the prescription), yet the patient never picks up the medication. A survey last year from Surescripts (a nationwide network connecting the computer systems of physicians and pharmacies) revealed that about one in every three patients who receive a paper prescription or have a prescription phoned/faxed in by the doctor’s office never pick up the prescription.
- Finally, there’s the frustrating scenario in which the prescription is turned in to the pharmacy of the patient’s choice, yet the pharmacy informs the patient that the prescription can’t be filled. Generally this is because the medication is a specialty medication which can only be filled by a specialty pharmacy, not a regular pharmacy. In addition, many payers have a limited number of specialty pharmacies to handle their patients’ prescriptions. Patients need to submit the prescription to the “right” specialty pharmacy as well as properly navigate the maze of prior authorization and related paperwork. At this point, many patients either lose motivation to find a solution or are confused about how to proceed. Once again, treatment is not started.
Whatever the sticking point, it’s a problem with serious ramifications. Obviously, these not-filled prescriptions were written for a reason; an untreated patient is vulnerable to disease progression, complications, and the potential for higher medical costs (for the patient and the payer) down the road.
So if physicians should not hand over prescriptions, just what should they do? The more effective way to connect a patient with treatment is to call or fax in the prescription to a specialty pharmacy, such as BioPlus Specialty Pharmacy.
With BioPlus, you and your patient will know within two hours whether the patient can be admitted. If the patient’s health insurance plan requires a different specialty pharmacy, then we will transfer the prescription and notify both the patient and the new pharmacy. Since BioPlus started our Two Hour Patient Acceptance Guarantee, our admission rate has increased by 12 percent. This speaks to the accountability of our admission team who prevent breakdowns of the diagnosis-treatment process – both for BioPlus patients and even for patients who are required to get their prescriptions from a different pharmacy.
What do you think
I’d love to hear your opinion in the comments section below.
Stephen C Vogt, PharmD
President and CEO
The National Progress Report on e-Prescribing and Interoperable Healthcare, Year 2011. Surescripts.com, May 17, 2012.