When it comes to prescription cost and quality, putting consumers in the driver’s seat

Published February 28, 2019

When it comes to prescription medications, the cost can sometimes be a shock. Patients may walk up to the pharmacy counter expecting to fill a prescription, only to learn that they can’t afford the co-pay. Doctors may not know just how much prescription drug costs are affecting their patients. And those costs are rising quickly. 

A tool for comparing costs

To help members shop for the most-effective and affordable medications—the way they might compare travel costs among different airlines—Regence Blue Cross and Blue Shield (Regence BCBS) companies operating health plans in Oregon, Washington, Idaho, and Utah, are offering members a new, easy-to-use service called MedSavvy. Signaling a commitment to empower members in managing drug costs, Regence has been an early adopter of the service and the health plans’ early feedback was essential in fine-tuning the service to drive value for employers and their members. 

One large Oregon employer encouraged its employees who take cholesterol medication to check their options with MedSavvy. The campaign resulted in 11 percent of those employees switching to lower-cost medications, decreasing their average cost per claim from $36.66 to $15.44.

“Any time we can help our members be more informed and in control of their care, it’s a win for everyone,” says Angela Dowling, a Regence executive. “It’s all about improving health outcomes while reducing costs.”

Reducing costs does not mean sacrificing quality, she says. And that’s baked into MedSavvy’s technology.

“Health plans need to encourage people to use the safest, most-effective drugs, while also helping them keep costs down,” says Sean Karbowicz, MedSavvy founder and general manager. “MedSavvy makes that information transparent and easy to understand for their members, and our pharmacists support those members to work with their doctors to make medication changes.”

Cost matters, but so does effectiveness

The first step in making prescriptions more affordable, says Dowling, is helping members know what they cost. “Our members deserve more insights into what they’re spending on their medications, whether they’re on their computers at home or sitting in a doctor’s office with a smart phone. But price transparency isn’t enough. They also deserve to know if their medication is the most effective for their condition. MedSavvy makes that easy through a simple letter grading system.” 

Doctors may not be aware of all the alternatives, which is why Regence BCBS wanted to help consumers compare medications for their conditions based on quality and costs, and then partner with their physicians to make the best decision. Consumers can then check their insurance coverage for a particular drug and find the best price at their preferred pharmacy, all of which is available to Regence members.

Improving quality and lowering drug costs through competition

By providing more transparency around drug prices and quality information, consumers are empowered with choices that can ultimately drive larger changes in the drug marketplace.

“Just like you buy anything else in a marketplace, you are going to compare costs and quality,” says Karbowicz.” That forces manufacturers to compete on costs and improve the quality of their products. MedSavvy also shows where you can buy the medication at the cheapest price based on your benefit. We’re bringing competition to pharmacies as well.”

Regence serves approximately 2.5 million members through Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (select counties in Washington). Each health plan is a nonprofit independent licensee of the Blue Cross and Blue Shield Association. MedSavvy is a separate and independent company that provides prescription comparison services for Regence Health Plan members.