People use many tactics to cut down the cost of their prescription drugs.
Not getting a refill when it’s time, taking over-the-counter medication instead of a prescription, cutting pills in half or skipping doses — these are all ways that a third of people in the United States have dealt with high drug prices, according to a 2023 study by the Kaiser Family Foundation.
The ongoing problem of prescription drug costs is astronomical. GoodRX found that the three most expensive drugs that are filled at local pharmacies in the United States — Zokinvy, Myalept and Mavenclad — all cost over $60,000 for a month’s supply. While these are the extreme, paying for vital medications and predicting the price tag is difficult for many Americans.
For the doctors prescribing the medication, finding out exactly what it will cost the patient can be a technical problem. Not all electronic health records and prescribing systems have the ability to access this information, much less in real time.
In an attempt to provide doctors and patients with some support, the Centers for Medicare and Medicaid Services began requiring all sponsors of prescription drug plans in Medicare to have at least one electronic real-time prescription-benefit tool on January 1, 2023.
DoseSpot, a healthtech company that specializes in ePrescription software, is ready and waiting to help with a real-time prescription-benefit functionality that is now part of the company’s platform. Built In spoke with Chief Technology Officer Michelle Kohut to get a behind-the-scenes look at building this capability.
What impact will real-time prescription benefits have for DoseSpot customers?
At DoseSpot, we’re committed to continuously enriching the healthcare experience. For over 13 years, our certified ePrescription software has empowered providers to streamline workflows and improve patient outcomes. With this ongoing commitment in mind, we wanted to help strengthen patient-provider relationships by introducing real-time prescription benefits directly into our prescribing environment.
Now, at the point of care, providers will be able to share out-of-pocket medication costs, coverage restrictions and prior authorization requirements in real time. This allows for more affordable care and reduces delays in getting needed therapies into the hands of patients. With DoseSpot, we are making it possible for this level of transparency to be the standard in patient care.
“Now, at the point of care, providers will be able to share out-of-pocket medication costs, coverage restrictions and prior authorization requirements in real time.”
What role did you play in developing and launching the product?
As chief technology officer, I lead the technical team. This team includes the software development, quality assurance and development operations members who work to evaluate, plan, execute and deploy the real-time prescription benefit functionality.
The team created a dynamic queueing mechanism that allows requests for real-time prescription benefit data to be directed across data provider networks easily. This creates a diversified, reliable platform for providers and their patients.
HOW DOES IT WORK?
Real-time prescription benefits allow a user to select a medication, which is then run through an algorithm that evaluates things like insurance eligibility, formulary information, prior authorization requirements and pharmacy location to find an exact amount that a patient will pay out of pocket. It can even suggest a lower-cost option.
A randomized clinical trial published in the National Library of Medicine found that real-time prescription benefits led to an 11 percent reduction in patient out-of-pocket costs for ordered medications and a 40 percent reduction for high-cost drugs.
What obstacles did you encounter along the way?
Our agile product and technical teams collaborated seamlessly throughout developing and testing real-time prescription benefits. Constant feedback loops ensured we were always on the same page, but there are always challenges.
Despite removing cost barriers and amplifying marketing efforts, we wanted higher adoption across providers. We understood providers’ time constraints — adding another step wasn’t ideal. So, we got creative. We seamlessly integrated real-time prescription-benefit data requests into the existing prescription workflow, making it instantly available alongside other key information. This eliminated extra steps and ensured real-time prescription benefit insights were readily accessible wherever providers needed them.
“We wanted higher adoption, so we seamlessly integrated real-time prescription-benefit data requests into the existing prescription workflow, making it instantly available.”
What teams did you collaborate with in order to get this across the finish line?
The technical team worked closely with other DoseSpot teams to launch real-time prescription benefits within the ePrescribing process. The product team led the evaluation of the business requirements and desired outcomes, while the marketing team created materials to highlight the benefits for our users. It was also necessary to work closely with the third parties responsible for providing the real-time prescription-benefit data.
As DoseSpot worked to consume the data, there were regular cross-team and vendor meetings, releases to a staging environment every two weeks, and many testing and training sessions to keep everyone on the same page.
When you think of other companies in healthtech, how does DoseSpot compare when it comes to how you build and launch new products?
DoseSpot has always been provider-centric. We focus our efforts on building technology workflows that positively impact providers and the patients they treat.
Our core values are not just for show but true descriptions of each individual employee.
We are transparent and trusted. We are relationship builders. We are changemakers.
