Medication accessibility is vital to help patients achieve their health goals. It reduces morbidity and mortality and increases health-related quality of life. Despite this, many people still face challenges accessing life-changing medications and remaining adherent to longer treatment regimes.
Medication access is a multi-faceted problem encompassing high costs, logistical issues, communication barriers and complex insurance policies. A fragmented system leads to delays, decreased patient satisfaction and an increased burden on healthcare professionals – time spent dealing with bureaucratic procedures is time away from treating patients. We need to disrupt the status quo of medication access, and we need to do it now.
The solution? A holistic mHealth approach which transforms the prescription journey and tackles multiple access challenges at the same time. Today, developers and researchers are creating a new paradigm for care – one which combines the power of new technologies, including advanced AI, and human experience to eliminate barriers and create a digital-first approach to prescription services.
The challenge of medication accessibility
One in four adults in the US say it is difficult to afford their prescription drugs and three in 10 report not taking their medicines as prescribed because of the cost. For those with long-term conditions, it can be a constant balancing act between vital medications and other household bills. One in five adults with diabetes report rationing insulin because of the cost. When patients are unable to take their medications correctly, it has major implications both in terms of adverse health outcomes for the individual and increased costs for care providers.
While the prices of medications vary, many patients are unaware that lower cost options are available, and prescribers often lack the time to search for cheaper alternatives. Insurance policies and practices can also limit access, with prior authorization (PA) a major pain point for prescribers and formularies leading to higher costs for patients.
Improving access and adherence for patients
Digital services can simplify the prescription journey for patients, helping them access medications at a lower price without having to shop around.
By using advanced AI-driven verification, we can analyze patient benefit information, historical medicines pricing, pharmacy data, and real-time claims adjudication to identify the best possible price for patients. The price can be brought down even further by automatically applying discounts and coupons from drug makers, helping patients to not just start but stay on treatment.
However, creating a digital infrastructure is about much more than just savings. A single prescription access platform can also be used to provide direct-to-patient (DTP) services or match patients with the best pharmacy for them. It can deal directly with insurance companies to get medications requiring PA filled more quickly. Once a patient has received their medication, adherence can be supported with patient education, simplified access, automated refill reminders, and integrated manufacturer support.
Combining advanced AI, digital infrastructure, and automation offers the opportunity to flex to meet different patient needs and build a complete data picture to optimize outcomes.
Reduced administrative burden for prescribers
Fragmented systems place a huge administrative burden on prescribers, with PA as a particular pain point. Nearly one in three physicians report PAs are often or always denied and this has a serious impact on patients and the wider system. Almost a quarter say PA has led to an adverse event for a patient and more than eight in 10 say it can lead to treatment abandonment. Nearly nine out of 10 healthcare professionals say PA leads to higher overall utilization of health care resources.
A unified digital platform can significantly reduce administrative overhead, freeing up prescribers to focus on patient care. An automated PA system cuts approval times and increases approval rates regardless of insurance restrictions while keeping prescribers informed about insurance coverage perquisites. With fewer delays and a personalized tech-plus-touch approach to adherence support, pharmacy callbacks decrease and patient outcomes improve.
At the same time, rigorous security protocols protect data, integrated electronic health records (EHRs) can provide additional checks against errors, and an automated process at each step ensures patients get the right medications for them every time.
By harnessing new technologies, we can eliminate frustrating delays in accessing patient medications, empower healthcare professionals to prescribe with confidence, and allow them to focus on what matters most – their patients.
Conclusion
Every prescription that goes unfilled represents a patient who is not receiving a needed therapy. Now is the time to break through barriers in a complex healthcare supply chain and ensure every patient can access cost-effective medication easily and quickly.
Achieving this requires the entire mHealth community, from developers and investors to providers and patients, to seize the potential of digital prescription services. The question should not be whether to embrace a streamlined, frictionless healthcare system empowered by technology but how quickly we can do it.
About the author
Chip Parkinson is the Chief Executive Officer (CEO) of Gifthealth, a pioneering digital pharmacy platform focused on accelerating patient access and innovation in pharmaceutical services. Chip leads the company’s strategic vision to transform the complex and fragmented patient journey, ensuring consumers receive clear, convenient, and affordable access to their prescribed medicines.