There’s a great pharmacy scene in the HBO series Curb Your Enthusiasm. The show’s star, Larry David, walks in with his father’s prescription and hands it across the counter.
The pharmacist takes one look and says, “You know, there’s another drug on the market that I personally like better. All my patients are a lot happier with it, too.”
Larry stares back at him with his trademark suspicion. “Really?”
Not knowing either drug, Larry begins to weigh the doctor’s prescription against the pharmacist’s suggestion. He alternates glances between each piece of paper, repeatedly asking aloud, “Doctor?” … “or pharmacist?” After several awkward pauses in between, he finally declares: “I’m going with the pharmacist.”
A lot of things in life get under Larry David’s skin but paying too much probably tops the list. We know Rx Savings Solutions members can relate. Since 2012, we’ve helped them—and the plans that cover them—save hundreds of millions of dollars. Most of those savings result from members “going with the pharmacist,” just like Larry did.
Dare We Suggest
RxSS software generates personalized recommendations based on each member’s prescription claims, formulary, pharmacy benefit design and deductible status. We find every lower-cost option and clinical alternative that exists for a member’s medications.
Often, the 36,000-plus suggestions curated by our pharmacists will require a new prescription. RxSS makes it easy for members to clear the hurdles and hassles in getting their doctor to approve it.
Prescribers approve RxSS member requests over 85% of the time with no questions asked. (Most denials are due to time passed since the member’s last exam.) However, some members can be apprehensive about a suggested switch.
Whom Can You Trust?
“How do I know if my doctor approves of the medication changes? Basically, I would want to know you have already discussed this medication switch with my doctor.”
“You’re not my doctor. How dare you tell me to change my medicine?”
The above are actual survey comments from two RxSS members. We understand their concerns and want to reinforce that:
- RxSS isn’t telling members what to do, only providing transparency into options and costs they likely didn’t know about.
- Any suggested medication switch will absolutely require their doctor’s approval before a new prescription is issued.
- Members can ask their doctor about our suggestions on their own, or they can have RxSS do it for them—and take care of every detail right up to the moment the lower-cost, doctor-approved prescription is ready for pick-up or lands in their mailbox.
Most people trust their doctor. Most also trust their pharmacist. Why should they trust RxSS? Because we facilitate prescription changes with doctors every day, and our suggestions come from PharmD’s who, by profession, have more intimate knowledge of the pharmaceutical landscape. They also have access to each RxSS member’s unique prescription and health plan data.
Whose Decision Is it, Anyway?
In a perfect world, doctors, pharmacists, care coordinators and health plans all have the same information with which to make the best decisions for patients. RxSS works with all of them because healthcare remains far from a perfect world. We choose to focus our solution on our members—i.e., the patient. They know their finances better than anyone. And no other party has more at stake.
Medication decisions are personal, after all. They should always be made in consult with the member’s doctor. RxSS delivers clinically sound, cost-conscious, pharmacist-vetted options to inform those discussions.
Some members prefer to have that conversation with their doctor. Others would rather avoid it. Either way, RxSS gives them options they probably didn’t know they had. “Doctor?” “Pharmacist?” The choice is always the member’s to make. RxSS is here to make it as easy as possible.