Addressing soaring drug prices

By Dan Danielson
Wednesday, October 10, 2018
Addressing soaring drug prices

We often hear from our customers that healthcare is complex and often too expensive. Providing important cost information at the point of care between a patient and their healthcare provider, is one important way to help address the affordability of care.

Managing the high cost of prescription medications is a concern for our customers and can have an impact on their health. Through the SPRINT Program at Premera Blue Cross, our team regularly identifies and takes quick action when we see a high-priced drug coming onto the market or when we see a sharp increase in price for an existing drug.

Our SPRINT program uses information we gather from a variety of sources, including broad market and industry resources, and pricing data from our pharmacy benefit manager partner, Express Scripts. We use this information to develop strategies for alerting providers and members about alternatives to high-priced drugs that may be just as appropriate for their specific condition. In many cases, this is simply a matter of raising awareness about a generic alternative, which in most cases can save 80-85 percent off the list price.

Recently, the manufacturer of the drug Nitrofurantoin announced they would increase the price of the generic antibiotic from $500 per bottle to $2,300 per bottle. This means the price a patient pays at the pharmacy for a Nitrofurantoin prescription may increase dramatically. Nitrofurantoin is commonly used to treat bladder infections in women and men.

generic-drugs-chart

Collaboration with providers

Our goal is to work alongside our providers as they write prescriptions for our customers. Doctors tell us that they want to ensure their patients can take the most cost-effective, appropriate therapy, and this program helps us do just that.

Below is an example of the letter we sent to providers about the Nitrofurantoin generic. We highlighted the price differences between alternative drugs so they have all the information when they need to prescribe a drug to a customer. 

drug-notification-sample

Dan Danielson is a senior clinical pharmacist at Premera Blue Cross.

Dan Danielson


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