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Using Technology to Prompt Prescription Cost Conversations With Older Adult Beneficiaries

Patients appreciate “accurate, real-time information on medication costs to inform decision-making,” researchers report. While healthcare providers can use real-time benefit tools (RTBTs) to facilitate conversations about costs with patients, the authors caution that “approaches that envision RTBTs as one-size-fits-all technological interventions may underestimate the complexity of incorporating price information into prescribing decisions.”

Adults aged 50 years or older who reported trouble paying for prescriptions were invited to participate in focus groups to characterize patient perspectives on cost conversations with physicians and identify factors that would influence the value of RTBTs that prompt such discussions. Participants had conditions requiring high-cost treatments, including 6 with cancer, 6 with diabetes, and 3 with rheumatoid arthritis. One focus group of 3 patients with lower incomes provided general input without regard to their medical conditions.

“Participants were between 50–74, eight self-identified as Black, 10 as White, and eight reported earning <$50,000/year.” the authors write. “We identified five themes regarding cost conversations (medication cost importance, past experiences with cost/cost conversations, perception of physician’s role and knowledge, knowledge of existing resources, and influence on decision-making) and four RTBT-use-specific themes (advantages/disadvantages, perceived relevance, data quality concerns, and implementation considerations).”

The authors provide these insights about their findings: “As currently designed, RTBTs often offer a one-size-fits all-solution wherein a ‘pop-up’ alert or warning appears for prescribers at the time of order based on a pre-defined difference in out-of-pocket medication costs. Our results indicate that this may substantially underestimate the complexity involved in providing financial advice and the heterogeneity in patients’ views on discussing medication costs.”

Source: Journal of the American Geriatrics Society