It’s a moment many physicians recognize: a prescription is written, clinically appropriate, carefully chosen but then … it’s never filled. Not because the patient disagrees. Not because of side effects. But because they can’t afford it.
Sticker shock at the pharmacy counter is one of the most common reasons patients cite for abandoning prescriptions or not taking their medications as prescribed. According to KFF, nearly one-third of adults reported skipping doses, splitting pills, or giving up treatment due to cost.
And physicians are often the last to find out.
In a recent Medscape article, Dr. Kevin Fiscella of the University of Rochester and others offered three evidence-based ways clinicians can help their patients navigate rising drug costs. The solutions are simple, actionable, and deeply human.
1. Ask the right questions
Many patients won’t bring up cost unless invited to. But how clinicians frame the conversation matters. Something as small as a waiting room sign or a routine question from nursing staff, like “Are you having trouble affording your medications?” can open the door to a productive conversation.
Dr. Fiscella found that a single one-hour training helped increase medication cost conversations from 17% to 32% in his study. That’s a meaningful shift, especially when every unfilled prescription represents a lost opportunity for care.
2. De-prescribe when appropriate
Polypharmacy, taking five or more prescriptions, is more common than many suspect, especially among older adults with multiple conditions. Approximately 24% of working adults are classified as polypharmacy. But not all medications on a patient’s list are still clinically necessary or cost-effective. A “brown bag visit,” where patients bring in all their medications for review, can uncover redundant, outdated, or low-value prescriptions.
Reducing medication burden helps more than the wallet. It reduces interactions, confusion, and the sheer cognitive load of managing complex regimens. Unfortunately, physicians do not have full visibility into their patient’s full prescription list.
3. Connect patients to assistance programs
Many physicians want to help but aren’t sure where to start. Fortunately, resources exist: HealthTech companies, coupon platforms, and educational tools like the JAMA Patient Page. Making the connections easy for physicians and their clinic staff makes this kind of help more likely to succeed.
The above three strategies are practical and evidence-based, but they can be limited by complexity and time. Clinicians are already under pressure. Office visits are short. Formularies are complex. And even when the will is there, the workflow often isn’t.
That’s where system-level solutions come in.
How RazorMetrics Helps Physicians
RazorMetrics was built to solve exactly this problem: filling in the gaps between cost, appropriateness, and prescriber time.
Our platform identifies lower-cost, therapeutically equivalent alternatives and routes the recommendation directly through the physician. If the prescriber approves the switch, only then is the member notified. There’s no second-guessing the clinician, no patient confusion at the pharmacy, and no disruption to care.
We also help plan sponsors target high-cost categories, including biosimilars, polypharmacy, and specialty drugs areas where the financial impact is most acute.
RazorMetrics makes it easier for physicians to help their patients afford the medications they’re prescribed without adding clicks, red-tape, or guesswork to an already time-pressured clinic.
