How Technology Affects Medication Access, Affordability and Adherence

In the last year, most of life’s essentials, including healthcare, have taken on a higher value and become more difficult to obtain. We’ve faced the threat of the COVID-19 pandemic together, as it’s exposed vulnerabilities throughout society.

If a year of uncertainty has taught us anything, it’s that a reliable path to medication access is of the utmost importance for patients. A crisis only intensifies the many access barriers and challenges already facing patients, from prior authorization (PA) to prescription affordability.

Here’s the good news: The impact of the pandemic has driven the adoption of innovative healthcare technology — including many solutions that can help patients access therapies while also improving processes for providers, pharmacists and payers.

Here, with data from our 2021 Medication Access Report, we highlight how a few of these solutions can improve medication access, affordability and adherence. (And for more, register for our upcoming HLTH panel.)

Access: simplifying processes while helping patients get their medications sooner

Patients’ medication access challenges range from coverage — the most recent estimates show more than 29 million Americans under age 65 were uninsured^[1]Health Insurance Coverage in the United States: 2019, The United States Census Bureau, 2020 — to benefit barriers like PA. In fact, one in four patients surveyed reported delays due to their medication requiring PA.^[2]CoverMyMeds Patient Survey, 2020

While healthcare technology can’t directly impact the number of un- or under-insured Americans, it can help them — and their providers — access their therapy sooner and, potentially, at a cost that’s more affordable.

An electronic prior authorization (ePA) solution not only simplifies a healthcare providers’ workday, it can decrease the likelihood a patient is surprised at the pharmacy. When a provider prospectively, or at the point of prescribing, sends a PA request via an ePA solution, patients get their meds an average of 13.2 days sooner.^[3]CoverMyMeds data on file, 2019 (See the adherence section below for speed to therapy’s impact.)

Affordability: a tool to help patients avoid sticker shock at the pharmacy

When medication costs too much, patients are faced with tough decisions and potential sacrifices, from postponing payment on bills to skipping treatment altogether.

See the 2021 Medication Access Report for a full list of the trade-offs patients reported making to help pay for therapy.

Consider this: More than one in three patients said they went without treatment or medications to pay for bills and basic needs.^[2]CoverMyMeds Patient Survey, 2020

What patients need most, perhaps, is greater transparency into the costs they may face — and potential alternatives.

Real-time prescription benefit (RTPB) technology enables providers, pharmacies and plans to quickly exchange patient benefit coverage and out-of-pocket cost information. By housing this data in healthcare workflow, providers can have productive conversations with patients during the appointment — without having to search for medication and benefit information in multiple locations. Point-of-prescribing solutions inclusive of RTPB are expanding to include medication alternatives and cash price. (Imagine: a future where all patients are equipped with information like medication price and alternatives up-front.)

While patients are willing to prescription price-shop, they often don’t know where to start or what’s available: 62 percent said they actively asked their provider about medication price and affordability options.^[2]CoverMyMeds Patient Survey, 2020 As many providers are limited by the information available in their electronic health record system (EHR), a tool that pulls medication information into their workflow can be incredibly beneficial.

Adherence: a support solution that can help patients start — and stay on — therapy

It’s an unfortunate, yet simple, reality: When patients can’t access their medication without delay or afford what their provider has prescribed, they’re less likely to adhere to it.^[4]8 reasons patients don’t take their medications, American Medical Association, 2020

The use of ePA and RTPB tools can positively impact adherence — a study shows that when providers use a decision-support solution like RTPB, patients are 19 percent more adherent with picking up their medication.^[3]CoverMyMeds data on file, 2019

The need for technological solutions is only increased for patients prescribed specialty therapies. Specialty dashboards and tech-enabled hub services that can electronically enroll patients during their appointment can help get them started on therapy sooner — and help patients and their providers navigate complex processes around benefits verification, pharmacy access and, of course, affordability.

In some cases, the use of these support services has contributed to a 34 percent reduction in time to therapy for patients.^[5]CoverMyMeds data on file, 2020

Overall, the increased visibility into the patient journey facilitated by this technology can help reduce prescription abandonment and medication non-adherence.

Healthcare needs patient-centered solutions

By enabling access, promoting affordability and supporting adherence, patient-centered solutions — like ePA, RTPB and tech-enabled hub services — can help lift barriers at each step of a patient’s journey.

For more on technology’s role in shaping the future of patient access, register for the upcoming HLTH panel moderated by CoverMyMeds President David Holladay. The panel features CoverMyMeds' 2021 Medication Access Report Advisory Board members:

• Nicole Braccio, PharmD, PRh, policy director for the National Patient Advocate Foundation
• Dr. Patrick McGill, executive vice president and chief analytics officer for Community Health Network
• Dr. Milisa Rizer, chief clinical information officer and professor of clinical family medicine for The Ohio State University Wexner Medical Center