California's Blue Shield launches new digital tool for drug transparency
California's Blue Shield introduced a new tool Wednesday to notify members when its clinicians start electronic prescriptions and allow them to compare lower-cost alternatives.
The new feature is called Price Check My RX and is powered by Gemini Health, a drug price transparency company. It can be found on the Blue Shield of the California mobile app. Check my RX with Price, members can see their doctor ordering new or updated prescription medications out of pocket price. Additionally, they are able to review potentially lower alternative drugs, view other in-network pharmacies or check discounts.
Clinicians who prescribe medications also receive the same information about low-cost alternatives when electronically prescribed. This way, they can make the best decisions with their patients.
“This information allows members and doctors to have good conversations, especially if they can't afford the drug,” said Salina Wong, senior director of the California Blue Shield Clinical Pharmacy Program. “A lot of the time, if members can't afford it, members will not be able to take chronic medications continuously, especially if they have to fill in multiple medications.”
Wong added that to measure the success of my new price check my RX tool, insurers are tracking savings, how often members receive notifications, how often they view information, and how many members choose lower-cost options.
The announcement comes after California-based Blue Shield launched another digital tool for members. In June, it partnered with Zocdoc, an online marketplace that helps patients find and make appointments with in-network providers. Through partnerships, Zocdoc's technology has been embedded in the Blue Shield of California's “Find Doctor” feature. This allows members to find real-time availability and appointments for providers directly through the insurer’s website.
In January, California-based Blue Shield also launched a new pharmacy management model that partnered with five different companies (Amazon Pharmacy, Cost Dosing, Abarca, Prime Therapeutics and CVS Caremark) with its prescription drug benefits. Amazon provides delivery services for prescriptions, with cost plus the transparent pricing model for drugs, Abarca handles payments for prescription drug claims, while Prime Therapeutics saves with drug manufacturers. CVS Caremark was formerly the only pharmacy welfare manager at Blue Shield, and is now in charge of professional pharmacy services.
Going forward, California’s Blue Shield plans to launch additional features to improve drug prices transparency and affordability, including services related to previous authorizations, Wong said.
“We really want to address the surge in drugs. It's not sustainable, but it's obvious,” she declared. “The lack of transparency and accountability is very worrying when you consider the fact: On average, the cost of drugs is almost three times that of other countries, and the gap is widening compared to other countries. … We can't continue to stick with such countries like this, so we really need to address this industry.”
Photo: Blablo101, Getty Images
