As the 2024 election heats up, the topic of high drug costs is making its way into stump speeches. Politicians at every level of government – from state, federal, and the executive branch – are promoting policy solutions to address growing frustration with drug prices across the country. In response, established healthcare players are pushing back against efforts to cap their profit margins. The continuing fight between government initiatives to lower costs and an industry resistant to change reveals a complex healthcare policy landscape. Amidst the clamor, health tech companies are filling in the gaps for patients and are emerging as a critical piece of the drug cost puzzle.
The Power of Data
In an era where data is king, HealthTech companies are successfully driving effective drug cost-control strategies by leveraging analytics, demographic statistics, and care team insights. Since Congress enacted the HITECH Act, which offered financial incentives to health facilities to adopt Electronic Health Records (EHRs), health information entered the digital age. The wealth of health data combined with new Artificial Intelligence (AI) improvements has dramatically increased the computing capacity to process and analyze mountainous volumes of electronic patient data and drug price information. Now, it is possible to direct patients to the lowest cost, medically equivalent medication based on their location, insurance carrier, formulary, and pharmacy. Yet, despite these advances, there is still a problem with getting the information to patients.
Primary Engagement Questions
Most HealthTech companies in the space are “member-first;” their primary contact is the patient. The strategy is to engage patients through email, texting, social media, or snail mail to convince them to download their prescription service. The member-first approach must trudge through the digital noise and spam, vying for their attention to gain trust and influence individual behavior choices. The effort behind member engagement is impressive and expensive because it is an uphill battle to convince people to download a new app and an even higher hill to keep them using it. According to App usage and revenue statistics, 2.6% of Android users and 4.3% of iPhone users will still be active 30 days after download.
Digital Barriers to Member-First Solutions
Even in 2024, in the U.S., there is a stark digital divide exposing the limitations of current drug savings programs. About 25% of U.S. adults with annual household incomes under $30,000 do not own a smartphone, and 43% do not have internet at home. Hence, when a drug savings model entirely depends on the patient’s diligence, the total savings possible are capped by the member engagement rate. Engagement will be low if the patient population has significant incidents of chronic health issues, low connectivity, or technology resistance.
For some disease management programs, member engagement is a foundational element of effective healthcare delivery because individual choices are paramount to success, like managing sugar intake for people with diabetes. However, for drug cost savings, it is increasingly conspicuous that focusing on member engagement has left out the primary authority on writing prescriptions – the physicians – resulting in a lopsided approach that falls short of effective cost control.
A Physician-First Approach: RazorMetrics’ Solution
RazorMetrics‘ “physician-first” model alleviates the burden on members, particularly those facing barriers related to income, connectivity, or chronic conditions. By designing a system around physician-first engagement, the solution removes the member-limited cap to maximize potential savings and improve health outcomes for every member. RazorMetrics boasts a 74% primary engagement rate by collaborating with physicians to review and approve lower-cost options for their patients. This approach leverages the trusted physician-patient relationship.
As the U.S. grapples with drug pricing reforms and patient engagement, it is evident that companies like RazorMetrics are paving the way toward a more effective solution by harnessing the power of technology and data. In this evolving narrative, the goal remains clear: to ensure that everyone, regardless of socioeconomic status or technological access, can benefit from healthcare affordability and access.
