DrFirst Passes 100 Million Real-Time Price Transparency Checks

myBenefitCheck^SM helps over 100,000 providers order medications patients can afford by sharing prescription coverage and cost information in prescribing workflows at the point of care

ROCKVILLE, Md., – Cost is the determining factor for patients deciding whether or not to pick up prescriptions waiting for them at the pharmacy. When medications are too costly, patients tend to abandon them regardless of their importance to their health.

Health technology pioneer DrFirst, the leader in real-time price transparency, has reached a new milestone in helping to reverse this trend. By processing more than 100 million benefit and pricing inquiries within prescribing workflows through its real-time myBenefitCheck tool, DrFirst gives providers and patients information on alternative medications that may be more affordable during an encounter.

DrFirst has access to drug pricing information for more than 324.5 million individuals, representing 90% of people covered by any health insurance plan, through its broad relationships with pharmacy benefit managers and other organizations. myBenefitCheck provides physicians with patient-specific, actual costs for prescribed medications as well as therapeutically appropriate alternatives. When prescribers have up-to-the-minute, accurate drug information based on a patient’s specific insurance benefits, clinicians and patients can discuss therapy alternatives and minimize or remove financial obstacles while they are face to face during an office visit or consultation.

“We’re proud to have crossed this important milestone for myBenefitCheck, which has steadily grown in adoption since its inaugural launch in late 2014 with Humana,” said G. Cameron Deemer, president of DrFirst. “Putting out-of-pocket cost information in front of providers at the point of prescribing eliminates one of the most significant obstacles to patient medication adherence and promotes conversations during an office visit that not only can save dollars but, more importantly, save lives.”

Studies have shown that patients are four times more likely to abandon a prescription that costs $50 versus one that costs $10. With myBenefitCheck, prescribers can check a patient’s out-of-pocket costs for both covered and non-covered drugs, suggest lower-cost alternatives if needed, and share opportunities for patient assistance programs that may lower costs even further. Deemer adds, “This tool has never been more important, as so many Americans are experiencing reduced income or job loss and may be struggling to afford their medications. ”

myBenefitCheck also alerts physicians when patients’ benefit plans require prior authorization for a medication, then suggests alternatives that may not need this approval, which helps reduce patient and provider frustration and gets patients on therapies faster.

“Today’s consumers increasingly expect personalized services on par with other industries, including understanding what their out-of-pocket costs will be for their prescriptions,” said Deemer. “Having access to this information, based on individuals’ health insurance benefits and formularies, in real time at the point of care, helps providers meet that expectation. It also encourages patients to more fully participate in their healthcare decisions, so they are more likely to adhere to their treatment plans.”

Pharmacy benefits manager Prime Therapeutics LLC is the most recent organization to collaborate with DrFirst to provide myBenefitCheck functionality within healthcare providers’ electronic health record (EHR) systems. Prime’s Real Time Benefit Check solution is now live for select Blue Plans, and more integrations are being implemented for other Medicare Part D and commercial clients. Prime serves more than 30 million members and is collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.

Insurers that offer Medicare Part D benefits can use myBenefitCheck to satisfy the Centers for Medicare & Medicaid Services (CMS) rule requiring the use of at least one real-time benefit tool capable of integrating with at least one prescriber’s EHR no later than January 1, 2021.

About DrFirst

Since 2000, DrFirst has pioneered healthcare technology solutions and consulting services that securely connect people at touchpoints of care to improve patient outcomes. We create unconventional solutions that solve care collaboration, medication management, price transparency, and adherence challenges faced in healthcare. We unite the Healthiverse—the interconnected healthcare universe—by providing our clients with real-time access to the information they need, exactly when and how they need it, so patients get the best care possible. DrFirst solutions are used by nearly 300,000 healthcare professionals, including more than 100,000 prescribers, nearly half of the EHRs in the U.S., and more than 1,400 hospitals in the U.S. and Canada. To learn more, visit www.DrFirst.com and follow @DrFirst.

DrFirst Media Contact

Sofia Kosmetatos
Amendola Communications for DrFirst
646-431-8423
skosmetatos@acmarketingpr.com