Disregarding the Doctor’s Orders Due to Cost

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In a nation where modern medicine has made remarkable strides, the fact that high prescription prices force people to disregard doctor’s orders is a profoundly concerning reality. The Kaiser Family Fund (KFF) recently released new consumer health data, “Public Opinion on Prescription Drugs and Their Prices,” and the findings are disturbing.

One in five adults reported they did not fill a prescription due to cost (21%), while 12% admitted to halving pills or skipping doses to save money. The financial burden of necessary treatments is proving too heavy for a significant portion of the population. Skipping treatment has far-reaching consequences, from exacerbating delicate health conditions to reducing overall quality of life.

Going without prescribed medications often leads to adverse health outcomes with rippling financial effects. Chronic conditions left untreated or managed inadequately add complications that worsen the individual’s well-being while also adding stress to an already strained healthcare system. From diabetes to hypertension, untreated conditions can result in hospitalizations and emergency interventions, further driving up healthcare costs.

The issue extends beyond individual health; it permeates society on every level. When individuals are unable to adhere to prescribed treatments due to financial constraints, the entire community pays the price. An increase in preventable hospitalizations strains healthcare facilities and resources, affecting the patients and healthcare professionals providing care. It is a downward spiral of decreased productivity due to health-related issues impacting the workforce and the economy at large.

The KFF reporting sheds light on a distressing trend that exposes the vulnerabilities of the U.S. healthcare system. High prescription prices are a crisis demanding comprehensive policy changes prioritizing accessible and affordable healthcare. So far, the government has been unsuccessful in regulating drug prices to ensure that life-saving medications are within reach for everyone regardless of socioeconomic status. The government focuses on pricing transparency, greater competition among pharmaceutical companies, and promoting generic alternatives.

While policy changes may be effective in the future, health plans and employers need solutions now. Using AI, RazorMetrics tackles the high drug cost problem by engaging physicians directly.

RazorMetrics was founded by a Cardiologist and a MedTech entrepreneur who identified the prescribing process as a serious and unseen problem. The issue is that physicians have the control to prescribe but not the precise information because too many factors affect a patient’s drug price: the formulary, deductible, pharmacy, rebate structure, and more. Without assistance, physicians cannot be expected to prescribe the lowest-cost drugs.

Up to now, almost all other drug cost solutions put the burden on patients to save money. This created more problems than solved – the patient was expected to download an app, conduct internet research, call their physician, contact the insurance carrier, and make multiple trips to the pharmacy. RazorMetrics broke through the limited patient-driven drug-saving quagmire with a machine-learning algorithm that reaches out of the data world and into physicians’ offices to change prescribing behavior. The tech puts prescribers in the driver’s seat to save their patients money at the pharmacy, and in turn, health plans and employers maintain a sustainable pharmacy benefit.

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Consumer Behavior Impacted by High Drugs, Says New Report

RazorMetrics, a healthcare technology company focused on lowering drug costs for health plans and self-funded employers, released their annual State of Drug Access report. The report is based on the findings of a consumer survey conducted through Pollfish, using a random sampling method of 1000 adults (18 years and older).


Copay Accumulator Confusion

Have you tried to read your annual health benefits handbook and given up after a couple of pages? Most people just check their yearly deductible and total out-of-pocket amounts but the formula behind that calculus is beyond the first few pages. Health plans and employers that offer insurance collect premiums, but they also try to share the direct costs through copays for doctor appointments and medications.

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