Blue Shield of California introduced a new tool on Wednesday that notifies members when their clinician begins an e-prescription and allows them to compare lower-cost alternatives.
The new feature is called Price Check My Rx and is powered by Gemini Health, a drug price transparency company. It is available in the Blue Shield of California mobile app. With Price Check My Rx, members are able to see their out-of-pocket price for new or renewed prescription medications ordered by their doctor. In addition, they’re able to review alternative medications that may cost less, see other in-network pharmacies or check for discounts.
The clinicians prescribing the medications also receive the same information on lower-cost alternatives when they’re e-prescribing. That way, they can work with patients to make the best decision for their medication.
“That information allows the member and the doctor to have a good conversation, especially if they can’t afford the medication out of pocket,” said Salina Wong, senior director of clinical pharmacy programs at Blue Shield of California, in an interview. “And a lot of times, members will not be able to take chronic medications consistently if they can’t afford it, and especially if they have more than one medication that they have to fill.”
To measure the success of the new Price Check My Rx tool, the insurer is tracking savings, how often members are receiving notifications, how often they’re looking at the information, and how many members are selecting lower-cost options, Wong added.
The announcement comes shortly after Blue Shield of California launched another digital tool for members. In June, it teamed up with Zocdoc, an online marketplace that helps patients find and book appointments with in-network providers. Through the partnership, Zocdoc’s technology has been embedded within Blue Shield of California’s “Find a Doctor” feature. This allows members to find real-time availability of providers and book appointments directly through the insurer’s website.
In January, Blue Shield of California also launched its new pharmacy management model, in which it teamed up with five different companies — Amazon Pharmacy, Cost Plus Drugs, Abarca, Prime Therapeutics and CVS Caremark — for its prescription drug benefit. Amazon provides home delivery services for prescriptions, Cost Plus Drugs offers a transparent pricing model, Abarca handles the payment of prescription drug claims, and Prime Therapeutics negotiates savings with drug manufacturers. CVS Caremark, which was previously Blue Shield’s sole pharmacy benefit manager, is now just responsible for specialty pharmacy services.
Looking ahead, Blue Shield of California plans to launch additional features for drug price transparency and affordability, including services related to prior authorization, Wong said.
“We really want to tackle the skyrocketing cost of drugs. It is just unsustainable, but that’s obvious,” she declared. “The lack of transparency and accountability is very concerning when you think about the fact that, on average, the cost of medications is almost three times higher than in other countries, and four times higher for brand drugs versus other countries, and that gap is widening. … We can’t continue to persist like this as a country, so we really need to tackle this as an industry.”
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