Overcoming Insulin's High Price Tag To Tame The Diabetes Beast

By Miriam Paramore, OptimizeRx

Diabetes continues to plague the healthcare industry, maintaining its status as one of the top public health issues in terms of clinical outcomes and cost. As providers continue to take on more risk within the framework of value-based care, population health initiatives must prioritize efforts to improve the outlook on this disease, and medication adherence is fundamental to any strategy.

Yet, diabetes presents a unique challenge for all stakeholders because the cost of the four most popular insulin types has tripled over the past decade. The Healthcare Cost Institute reported in January 2019 that the average person with type 1 diabetes spent $5,705 annually on insulin.

The harsh truth is that the skyrocketing cost of insulin has made treatment unreachable for many patients. A 2019 study revealed that 25 percent of diabetic patients skimp on insulin in order to cut costs. Additionally, patients who reported compromising on insulin treatment to save money were more likely to have poor glycemic control than those who regularly use insulin—a problem that can deliver catastrophic, costly results.

Despite the bleak situation, many in the industry are finding hope through better pharma-provider partnerships. As EHRs continue to dominate physician’s workflows, a new opportunity exists for these two stakeholders to collaborate where help is needed most: at the point of care.

Adherence And Cost

A 2014 study of the relationship between adherence and healthcare cost found that providers often serve as the most powerful predictor of medication adherence. For both low- and high-income patients, the physician’s ability to educate the patient and reduce out-of-pocket cost improved medication adherence across a variety of diagnoses.

Because patients look to providers for medication information and treatment options, physicians working on the frontlines of care are uniquely positioned to share drug savings information with their patients and help them find the most affordable options for care. A 2018 study by SureScripts noted that 74 percent of providers believe it’s important to consider a patient’s benefits before prescribing a specific medication, and 59 percent of those want the ability to compare similar medications.

Given that patient adherence is so closely tied to medication cost, physicians rightly recognize that the improved outcomes the industry at large is seeking rely largely on the ability to identify the best drug at the best price when providers and patients are face to face.

Merging Workflow

Every year, billions of dollars in drug vouchers and coupons go unused, partly because providers and patients are unable to access them. For consumers, the network of manufacturer savings cards and pharmacy coupons can be confusing and overwhelming.

By prescribing those medications that are covered by patient insurance, providers can reduce out-of-pocket costs for diabetic patients. In addition, uniting e-prescribing providers and pharma companies through electronic communication can increase patient access to vital drug vouchers and coupons that provide medication cost relief. Platforms exist that allow pharmaceutical companies to communicate drug cost information and discount opportunities directly into the EHR, allowing providers to search for a drug by name, gain real-time access to coupons and vouchers and present them to the patient at the point of care.

In fact, in 2017, PM360 surveyed providers about drug affordability challenges and found that lower drug costs resulted in higher persistence, faster speed to fill and increased likelihood to stay on prescribed medications. The study also noted that three-fourths of providers changed their brand choice once a week to accommodate affordability concerns, with more than one-third changing their choice once a day. These providers point to manufacturer-sponsored co-pay coupons as an effective tool for managing drug costs.

Controlling Costs

The American Diabetes Association estimates that diabetes management for diagnosed cases of the disease costs $327 billion annually and presents a substantial burden for patients and providers alike. Worth noting, too, is the fact that these figures don’t include the millions of Americans who have undiagnosed prediabetes.

As the U.S. government pushes for drug pricing transparency in an effort to bring down drug costs, drug manufacturers that communicate savings to providers will position themselves to become the physician’s drug of choice, help patients stretch their medication dollars and aid providers in providing affordable care and maximizing outcomes.

Where physicians previously maintained sample closets and copay starter kits, the EHR is displacing those methods in exchange for real-time information about medications and cost. Almost 90 percent of providers and 85 percent of patients welcome the inclusion of EHR-based copay offers and information. Given that physicians spend a large part of their day engaged with EHR platforms, the information provided there can expedite visits by putting treatment options at their fingertips. Additionally, 75 percent of patients report improved perceptions of providers after receiving this kind of drug support.

As technology improves and patients become more actively involved in their own care, pharma-physician partnerships have the potential to increase patient engagement and improve patient outcomes. Direct communication allows providers to determine when patients aren’t adhering to medication schedules, identify the cause of the breakdown and close the care gap.

Brands that actively guide the conversation and support conversations between prescriber and patient will position themselves for better brand loyalty and increased consumption. Physicians who embrace the partnership will improve patient outcomes and improve care for their diabetic patients even while they strengthen their own personal brand.

About The Author

Miriam Paramore is President of OptimizeRx.