Prescription drug transparency and cost reduction

The client provides a digital pharmacy platform connecting payers, providers, pharmacy, and patients to manage costs and improve the healthcare experience. Prescription drug transparency drives efficiencies, maximizes savings, and above all—supports the health and well-being of people. With prescriptions alone representing over 30 percent of all healthcare costs and the average consumer spending $1,200 out-of-pocket annually, there’s a significant need to be addressed.

Challenge

Patients and providers are mostly unaware of prescription costs when prescribing, which causes issues at dispensing pharmacies when a prescription is either too expensive for the patient, requires prior authorization from the payer, or is not covered by the payer’s formulary design. The early-stage organization was exploring the viability of a market solution to address this issue.

Gavant Solution

Gavant built a HIPAA-compliant solution on AWS to aggregate and present data from various sources, including insurance benefits details, retail pharmacy locations, and copay assistance information. The resulting web portal enabled prescribing providers to discuss affordability and coverage at the point of prescription so that non-adherence of the prescribed drugs could be reduced. Users could search for a patient’s pharmacy benefit information and use that to compare pricing on different medications.

Impact

The new application proved the market opportunity, paving a path toward disruption to traditional pharmacy benefits models. With prescription drug transparency, the client is serving various stakeholders throughout the industry. Pharmacy benefit managers are able to lower Rx costs, optimize formulary adherence and improve client retention. And providers are able to maximize payer incentives and meet mandates, while reducing costs and administrative burden.