With getting the right prescription the first time an essential step to achieving better health outcomes, a number of digital innovations may help plan members, sponsors, doctors and pharmacists achieve that goal, according to Vincent Ng, health business consulting senior manager at Telus Health.
With drug plan costs on the rise, sponsors have been implementing more complex plan designs to ensure sustainability and coverage, Ng told attendees at Benefits Canada’s recent Pharmacy Solutions in Drug Plan Management Forum in Mississauga, Ont.
There are repercussions, however, due to the need for administrative work by and on behalf of patients in order to determine drug coverage, he noted.
The solution, according to Ng, is to get the plan member the right prescription from a clinical and drug coverage perspective at the first visit to a doctor, rather than after a number of phone calls or appointments.
Read: Mail-order pharmacy touted as a way to boost drug adherence
As Ng explained, there are four ways to achieve that. The first is through prescription exchange, which allows for the electronic transmission of the prescription from the doctor’s electronic medical system.
Although electronic prescribing isn’t yet widespread in Canada, Ng said it has proven popular in many other countries. He cited the 3.8 million electronic prescriptions filled in the United States every day.
Another key innovation is the ability for doctors to validate a patient’s drug coverage at the point of prescribing, said Ng, noting that would eliminate unnecessary communication between the physician and the pharmacy and reduce delays in starting treatment. Participating carriers in certain provinces currently offer that option.
Also, by implementing pharmacogenetic testing — which builds on the idea that everyone has a unique genetic makeup and responds differently to a drug at a particular dose — plan members may be able to avoid the prospect of taking less suitable drugs and delays in starting the right treatment.
Read: A look at the services pharmacists can provide
“We know that a lot of prescriptions that are prescribed and dispensed are very ineffective right now, because the dosages aren’t suitable for all patients because of genetic differences in individuals’ abilities to metabolize drugs,” said Ng.
For plan sponsors, pharmacogenetic testing would minimize the time-consuming and costly search for optimal therapies.
Ng also expects to see automation of the prior authorization process in Canada by 2019, which would minimize the interactions between carriers, doctors and plan members; reduce delays in starting treatment; and improve the customer experience.
Read more stories from the Pharmacy Solutions in Drug Plan Management Forum