Practical ways to help your patients afford their prescriptions

Patients' concerns about out-of-pocket prescription costs are a leading reason why they do not take their prescribed medications, which can have serious health consequences. Yet most patients will not mention their cost concerns unless specifically asked.

To screen for and manage patients' cost-related medication concerns, consider this three-step approach.

1. Have your staff conduct a one-question screening.

To normalize conversations about prescription costs, train staff to use simple, straightword language and ask every patient: “Is the cost of any of your medications a burden for you?” Screening at the point of medication reconciliation is often the most natural time for this. Alternatively, practices that have patients complete a self-administered questionnaire before their visits could incorporate this screening question.

Delegating this first step to staff reduces the burden on the physician and engages the care team. Additionally, some patients may be more apt to share information about their nonadherent behaviors with nursing or other office staff than with their physician.

2. Use brief cost-reduction strategies during the visit.

After reviewing any prescription concerns with the patient to identify causes, the physician then considers possible strategies:

• Review the necessity of the patient's medications, and offer a deprescribing trial when appropriate.
• Use extended (e.g., 90-day) prescriptions to reduce copayments, improve medication adherence, and reduce practice time devoted to processing refills.
• Substitute a less costly medication, or use discount programs such as the “$4 lists” offered by most large chain pharmacies. Even patients with adequate insurance coverage may benefit from using these drug lists.
  
• Use websites and apps such as https://www.goodrx.com that provide comparative costs between pharmacies and coupons for prescription medications.

3. Refer patients who need more assistance.

Some patients may require more intensive support, such as help navigating insurance plans, determining eligibility for additional insurance coverage (such as low-income subsidies), and applying for pharmaceutical medication assistance programs. If your practice does not have a care manager or social worker who can assist with these cases, identify another member of your staff who can serve as a champion and provide assistance, or connect patients with local health systems that may have resources available to assist them.

For additional training on this topic, check out the AAFP CME course Addressing Cost of Medications (20 AAFP prescribed credits).

Read the full article in FPM: “A Practical Approach to Reducing Patients' Prescription Costs.”