F135 Why is Medication Price Transparency in the US Complicated and Problematic? (Carm Huntress)

Because US healthcare is private and operates by the rules of the free market, prices for services and medications can differ substantially. Solutions such as GoodRx and Amazon Pharmacy are addressing price transparency for consumers. On the other side are the Real Time Prescription Benefit Providers which help physicians see drug prices for a specific patient even before that patient leaves their office. The challenge with knowing how much a drug will cost a patient lies in the fact that different insurance companies have different policies regarding how much they will pay for medication. Patients might have a plan with high deductibles. But it’s not just the provider and the insurance company: prices depend on the Pharmacy Benefit Managers (PMS) - intermediaries that manage prescription drug benefits on behalf of health insurers. PBMs negotiate prices with drug manufacturers and pharmacies. 

In this episode, Carm Huntress, the CEO of RxRevu Real Time Prescription Benefit Provider company, talks about the upcoming challenges of prices related to precision medicine, how drug pricing affects prescribing and treatment, and how price transparency can change the medication prescribing process.

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Episode summary: www.facesofdigitalhealth.com/blog/rxrevu-drug-pricing