Lupin 2023

Taking cost, coverage guesswork out of prescribing

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When a doctor prescribes a medication to a patient, neither party wants to be wondering about drug cost and coverage — an all-too-common situation that all too often makes things more difficult for the pharmacist as well.

UnitedHealthcare and its OptumRx PBM aim to help reduce that occurrence with PreCheck MyScript, a new online solution that gives provider and patient cost and coverage information when a drug is prescribed.

According to the company, PreCheck MyScript provides precise cost information based on the patient’s benefit plan and patient-specific pharmacy information and insurance coverage details to health care professionals at the point of drug prescribing. Phone calls or faxes aren’t needed for prior authorizations, which are automated.

The result: lower costs, more timely prescriptions, less administrative hassle and a better patient experience, UnitedHealthcare said.

Doctors who prescribe a medication via PreCheck MyScript can view exact prescription pricing information for the selected pharmacy and be alerted to drugs that require prior authorization, aren’t covered or are nonpreferred on a patient’s drug plan formulary.

The solution will provide alternative, lower-cost medicines that may not require prior authorization before they are sent to the pharmacy, UnitedHealthcare noted. If the drug needing a prior authorization is still prescribed, physicians can submit the authorization online and, in some cases, get immediate approval.

“Physician practices will spend more time with their patients and less time on administrative tasks,” according Sam Ho, chief medical officer at UnitedHealthcare. “It takes the guesswork out of determining whether a prescription is covered by the patient’s benefit plan and if prior authorization is needed. PreCheck MyScript also improves the patient experience due to the more precise cost information that is shared before the patient leaves the doctor’s office.”

PreCheck MyScript is embedded directly into a health care provider’s workflow if they are using an EMR platforms that integrates the tool. OptumRx and UnitedHealthcare are working with DrFirst, Allscripts and other EMR partners to integrate these capabilities at the point of care for prescribers. UnitedHealthcare said that by incorporating PreCheck MyScript into the provider’s EMR, doctors can seamlessly view prior-authorization information and drug costs and send the script to the pharmacy without having to switch applications.

“Allscripts is partnering with UnitedHealthcare to get pertinent prescription pricing information to doctors and their patients as quickly as possible,” explained Jay Bhattacharyya, vice president and general manager of payer and life sciences at Allscripts. “Through our partnership, we’re delivering real-time information on medication, empowering clinicians to make more informed decisions and provide better patient care.”

UnitedHealthcare said its the first health plan to offer PreCheck MyScript, now available to all care providers in its network. Plans call for OptumRx will offer the tool to more clients early next year.

“By making it easier for doctors to access pricing and coverage data, we foster more open communication between physicians and their patients about drug costs and quality, thereby improving health outcomes and the patient experience,” commented G. Cameron Deemer, president of DrFirst.


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