In a Buzz Health survey of prescribers, 54% said patients often or very often fail to start therapy because of cost, but only 17% said prescription abandonment is highly visible in their workflows. Joseph Kleiman, president of Buzz Health, says the gap comes down to connectivity: prescriber, pharmacy and health plan systems that still don't share data.

Medical Economics Managing Editor Todd Shryock sat down with Kleiman to talk through the survey, which included prescribers and electronic health record (EHR) workflow leaders.

Nearly all prescribers in the survey said seeing insurance and discount prices side by side in the EHR would be extremely or very valuable, and when cash or discount pricing was available at the point of prescribing, it was chosen most often. Kleiman explains why that doesn't necessarily make insurance the worse deal, what it costs patients and practices when price comparisons happen after the visit, and what he would tell the primary care physician who has stopped trying and tells patients to search for a coupon. He also weighs in on the role artificial intelligence (AI) could play and whether federal attention on price transparency is moving things in the right direction.

Music Credits:
Ocean Calm by Cephas - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using artificial intelligence (AI) tools.

0:00 – 0:15 | Cold open. Kleiman on cash prices and surprises at the pharmacy counter.

0:15 – 1:14 | Introduction. Austin Littrell introduces the episode and the guest.

1:14 – 2:23 | Why patients don't start therapy. Todd Shryock welcomes Kleiman, whose company's survey found 54% of prescribers say patients often or very often fail to start therapy because of cost. Kleiman says the problem persists because prescriber, health plan and pharmacy systems still don't share data.

2:23 – 3:15 | Closing the feedback loop. Only 17% of prescribers said prescription abandonment is highly visible in their workflows. Kleiman says fixing that takes systems that deliver results in one centralized location, and that it hasn't been a priority rather than something anyone opposes.

3:15 – 4:04 | Pricing inside the EHR. Nearly all prescribers said side-by-side insurance and discount pricing in the EHR would be valuable. Kleiman says nothing is standing in the way, and the technology can already deliver real-time pricing at the point of prescribing.

4:04 – 5:12 | Cash price vs. insurance. When cash or discount pricing is shown at the point of prescribing, it gets picked most often. Kleiman says insurance isn't necessarily the worse option, but prior authorization and deductibles create friction that surfaces at the pharmacy.

5:12 – 6:10 | The cost of sorting out prices after the visit. When price comparisons fall to staff or patients after the appointment, Kleiman says the uncertainty leads to abandoned prescriptions.

6:10 – 7:04 | Primary care's role in affordability. Kleiman says primary care physicians want an active role, and connecting pharmacy, prescriber and health plan will let them play a bigger part in the prescription journey.

7:04 – 7:56 | P2 Management Minute. Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.

7:56 – 8:46 | A message for health systems and administrators. Kleiman says the technology is there and isn't difficult to implement, and that better adherence helps costs for practices and health plans.

8:46 – 9:40 | For the physician who's given up. Kleiman on patients quoted one price who find another at the pharmacy, and his message that solutions now exist through the EHR and health plans.

9:40 – 10:33 | Where AI fits. Kleiman says AI can play a big part, but data sharing must be permitted and the work done carefully in a heavily regulated industry.

10:33 – 11:21 | Are things getting better? Kleiman points to CMS and legislative action on price transparency and says the remaining work is tying systems to a single source of truth.

11:21 – 12:00 | Final thoughts. Kleiman urges pharmacies, prescribers and health plans not to push pricing transparency aside.

12:00 – End | Outro. Littrell wraps the episode and points listeners to Medical Economics and Physicians Practice coverage of the MGMA Annual Conference in San Antonio, Sept. 27-30.

S1 Ep188: Why your patients don't fill prescriptions, with Joseph Kleiman of Buzz Health

Off the Chart: A Business of Medicine Podcast

S1 Ep188: Why your patients don't fill prescriptions, with Joseph Kleiman of Buzz Health