Real-time prescription benefit tool lifts fill rates for high-cost drugs, study finds

A real-time prescription benefit (RTPB) tool did not change overall prescription fill rates but did increase fill rates for high-cost medications, according to a post hoc analysis of a cluster randomised clinical trial published in JAMA Health Forum.

RTPB tools sit within the electronic prescribing workflow and show clinicians a patient’s expected out-of-pocket cost for a selected medication, alongside lower-cost alternatives where these are available. The intention is to allow cost to be factored into prescribing decisions at the point of ordering rather than at the pharmacy counter, where an unexpected price can lead to a prescription going unfilled.

The analysis found no difference in fill rates across all prescriptions written. When the researchers looked specifically at high-cost drugs, however, prescriptions were more likely to be filled when the tool was in use. The effect was most pronounced among patients from low-income communities, the group for whom out-of-pocket costs are most likely to act as a barrier to starting treatment.

The authors note an important limitation. The RTPB tool generated recommendations for only a small proportion of prescription orders, which means the findings apply to a narrow segment of the randomised population rather than to prescribing as a whole.

The corresponding author is Sunita M. Desai, PhD, of the Department of Population Health at NYU Grossman School of Medicine.

Read the full study: Real-Time Prescription Benefit Tool Availability and Prescription Medication Fill Rates