In today’s healthcare landscape, the rising cost of medications can pose significant challenges for patients. While we know that many individuals struggle to afford the medications they need to maintain their health and well-being, we also know that sorting through all of the savings options is not an easy task. There are an ever increasing number of options to sort through and each of those options can vary widely based on the specific pharmacy chosen. While not all of these different options fall under the framework of a ‘preferred pharmacy network,’ it is helpful to think of them as such. So, the question becomes, how can we leverage the power of preferred pharmacies (i.e. negotiated contracts) to unlock savings for the average patient?
Preferred pharmacy channels are partnerships/contracts established between pharmacies and healthcare plans, such as insurance companies, pharmacy benefit managers (PBMs), and/or savings card providers. These channels aim to promote cost savings by designating specific pharmacies as preferred providers for prescription medications. Patients who utilize these preferred pharmacies can access significant discounts, lower copayments, and other cost-saving incentives.
In recent years, preferred pharmacy networks have started to become a central component of most benefit plans and are a key way to help reduce the overall medication affordability burden. This is primarily accomplished by encouraging higher patient volumes for preferred pharmacies with lower cost structures over non-preferred locations. In some cases, the price at a non-preferred pharmacy versus a preferred pharmacy can be 2-3 times higher for the same medication simply due to the negotiated/contracted rate at a particular pharmacy. Given the number of available pharmacies, plans, PBMs, and third-party contracts, it quickly becomes difficult for both patients and their health care providers to determine the most affordable option.
In a recent study, the USC Schaeffer Center for Health Policy & Economics published data showing that even Medicare Part D patients could have saved over $147/year (~23% of their yearly medication spending) simply by leveraging the power of a preferred pharmacy network. Evidence showed that few patients ultimately took advantage of this benefit and this study didn’t account for opportunities that exist outside of the Part D structure itself which could have provided an even greater impact.
As you can see, these preferred pharmacy channels have emerged as a vital tool in the quest to make medications more affordable for all patients. By partnering with specific pharmacies, these channels unlock a range of cost-saving benefits which reduce financial burdens and improve medication adherence. However, while preferred pharmacy networks have been growing in popularity for over a decade, few patients fully understand how these networks can benefit them personally in their annual medication spending. It is impossible to overstate the importance of presenting this option, within the context of all of the other available options, to patients in a simple and easy-to-understand way.
RxLink’s mission is to do just that. Our MedMap™ is the first step on the journey as we begin to demystify complex pharmaceutical pricing models and empower patients with information that impacts both their health and their wealth. It’s our belief that as patients and healthcare professionals alike become more aware of the advantages offered by these options, we can foster a healthcare system where affordable medications are accessible to all, ultimately promoting better health outcomes for everyone.