The joint services are unique in combining robust patient-specific drug cost decision support, including lower cost alternative drugs, all at the point of prescribing, to empower busy prescribers with actionable information to lower drug costs. “Patient-specific drug costs are essential to selecting lower cost drugs given the complexity of prescription drug benefits, including 5-tier formularies, co-insurance, high deductible plans and Part D donut holes,” explained Edward Fotsch, chief executive officer of Gemini Health. He noted, “We’ve heard repeatedly from prescribers that the only thing worse than no drug costs is the wrong cost, so generalized cost information or drug cost approximations are of little value in the exam room.” Together, Gemini Health and Surescripts offer true drug savings for alternatives absent coupons, co-pay cards and related services designed to defeat plan formularies, and that promote the use of expensive, brand-name drugs.
“We’re thrilled to welcome Gemini Health and the health plans they serve to the Surescripts Network Alliance. Our combined prescription price transparency services ensure physicians prescribe medications that are aligned with their patient’s benefit plan, with minimal influence from external interests,” explained Tom Skelton, chief executive officer of Surescripts. “By delivering price transparency at the point of prescribing, we can improve patient adherence and clinical outcomes and reduce time and money spent on administrative tasks.”
The work between Gemini and Surescripts enables payers, including Blue Shield of California and other health plans, to easily deliver the Gemini Drug Cost Transparency Services to their prescribers through Surescripts Real-Time Prescription Benefit service. The combined services are available to any payer that chooses to integrate their prescription data with Gemini.
“Gemini’s drug cost decision support integration with Blue Shield of California’s formularies and prescription claims processing, combined with Surescripts’ national network and EHR integrations at the point of prescribing, will deliver the depth and breadth of drug cost information that our network providers need to help improve prescription adherence and reduce healthcare costs for our members,” said Terry Gilliland, Blue Shield of California’s senior vice president and chief health officer.
Gemini is the latest industry partner to select Surescripts as the vehicle to deliver real-time cost and benefits information to prescribers. Surescripts Real-Time Prescription Benefit delivers actionable patient intelligence to the point-of-care, so physicians can see how much a medication will cost their patient based on their specific health plan coverage. With these insights, prescribers and patients can work together to choose the drug option that is both medically appropriate and most affordable.
The new service will be available for general release prior to year’s end.