Pharmaceutical drugs can be costly, posing an issue for both the patient and the payer. Pharmaceutical companies can manage these high drug costs by implementing risk management programs. These programs allow companies to reduce their own spending while lowering drug costs for patients. Adopting a risk management program can be highly rewarding for pharmaceutical companies—particularly as it allows them to reduce health costs and gives customers a financial incentive to choose their products.
Can an RDUR Reduce Spending?
One method for drastically reducing spending is by using a retrospective drug utilization review program (RDUR). This program is an interventional program that goes over the claims data to identify instances of fraud, overuse, or medically unnecessary care. By investigating patterns in the claims data, an RDUR program offers prescribers lower-cost options and reduces the amount of money being lost by medically unnecessary care or overuse. This decreases overall costs for prescribers because it allows them to reduce unnecessary spending and choose lower cost plans.
Choosing Alternative Products
Another way of reducing drug spending is by choosing alternative, lower-cost products. Pharmaceutical companies can do this by consulting with a clinical pharmacy organization and choosing the cheaper options on their formulary. For instance, a company may purchase products not preferred on their formulary and consequently end up paying a premium. Being knowledgeable about which products are preferred on their formulary enables companies to save up to 30% by finding lower cost alternative products and avoiding costly premiums.
Encouraging Patient Adherence to Medications
It may seem like patient compliance with medications does not affect the overall cost of the medications, but this is wrong. In fact, patient adherence with medications is a huge issue in the healthcare industry, costing the US healthcare system an estimated $100 billion and $289 billion annually. This is because if patients do not follow their treatment plans, they often end up exacerbating their health conditions and accrue debt by spending time in the emergency room. To encourage patients to adhere to their medications, some companies have set up specialized call centers. These centers intend to help start a conversation with patients—discussing with patients the necessity of staying compliant with their treatment plans and investigating reasons patients may fall out of compliance. By serving as an educational resource for patients, and providing patients with reasons to stay compliant with their medications, call centers can lower drug costs for healthcare companies.
Although drug costs are often very high for pharmaceutical companies, it is possible to be proactive and set up interventional programs or call centers to reduce health spending. By taking a cost-effective approach, pharmaceutical companies can not only lower their own health costs but also those of their customers.
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