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OCHSNER HEALTH NETWORK PRESCRIBERS SAVE PATIENTS MORE THAN $5.1 MILLION

June 26, 2024
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Since 2021, Ochsner Health Network physicians have saved their patients more
than $5.1 million in pharmaceutical copays using the Real-Time Pharmacy Benefits
tool embedded within Epic. This digital tool alerts physicians if a lower-cost
alternative to a patient’s prescribed medication is available.

> “With Real-Time Pharmacy Benefits, prescribers can see the cost the patient
> will pay out of pocket when they pick up their medication at the pharmacy,”
> says Matthew Malachowski, PharmD, MHA, BCPS, System Director of Population
> Health and Ambulatory Care at Ochsner Health Pharmacy. “This is not an
> estimator tool. It is the actual contract price the patient can expect to pay
> for this medication with their current insurance at the selected pharmacy.”

The alert helps prescribers identify generic and brand-name prescription drugs
covered by the patient’s health insurance plan. If a similar product is
available at a lower patient cost, an alert pops up in Epic when the provider
orders the original medication. The pop-up displays the alternative product’s
name and required copayment.

Highlighted medications are in the same therapeutic class but available at a
lower cost to the patient, typically because they fall within a preferred
formulary tier. If this alert appears while the patient is in the room, a
physician can discuss the benefits of each medication as well as their costs,
reducing the chance of sticker shock or even prescription abandonment at the
pharmacy counter.

> “Using Real-Time Pharmacy Benefits has transformed my practice,” says Lee
> Montgomery, MD, a family physician in Baton Rouge. “It’s easy to use and
> patients appreciate the effort to make their care more affordable. I highly
> recommend adding this tool to your practice to boost patient satisfaction and
> improve outcomes,” says Dr. Montgomery.

This program is live across Ochsner Health’s instance of Epic for all
facilities, partners and prescribers.

> “We understand not all recommendations are exactly what the prescriber is
> looking for, but with incremental increases in utilization, patient savings
> will increase exponentially,” says Dr. Malachowski. “Our current acceptance
> rate—the rate at which prescribers accepts the alternative drug recommendation
> via the Epic alert—is 20% systemwide,” says Dr. Malachowski. “We would like to
> see that grow to 25%.”

As for Dr. Montgomery, his acceptance rate is 39%, which accounted for 92% of
total possible savings (the remaining recommendations were associated with very
low-level discounts on alternatives). “I love being able to tell my patients
that they can get the same effective medication at a fraction of the cost,” says
Dr. Montgomery.

Note: A recent Epic upgrade has slightly impacted the tool, creating some
ambiguity in the information that is displayed. Currently, Epic displays a
medication’s active ingredient only. In some cases, the provider will see the
same active ingredient and dosage, with one at a lower cost. For instance,
epinephrine 0.3 mg is shown twice instead of EpiPen versus Auvi-Q, which would
save a patient $50. The tool remains functional, and the Real-Time Pharmacy
Benefits team is working to improve that specificity.

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