UCHealth has been using RTBT since 2019. Now that it is a federal requirement, over 70% of health systems have this deployed. We discuss our lessons learned in deploying this tool:
- When to interrupt the prescriber for an alternate med that might save the patient $ ($2 monthly savings or more), and perhaps to restrict geography for internal pharmacy alternatives
- How to display Colorado Medicaid costs alongside the $0 copay for patients. (Eg both valsartan and losartan are $0 for patients but one might cost Medicaid a lot more) we can’t yet display 2 costs to the prescriber. Development opportunity for the Epic Wisconsin team
- How to get PBMs pharmacy benefit managers to clean up their own databases and suggested alternatives to show more relevant choices. Eg don’t show me creams and inhalers as alternatives when I’m prescribing prednisone steroid in oral form for asthma.
- Many prescribers don’t understand Medicaid issues above, and then only care if there is a prior authorization or a much bigger copay difference between alternatives.
- Using Arrive health and Surescripts. Worth working with both RTBT vendors in detail to improve data feeds.
- Still, patients save over $600,000 per year in copay costs because of alternatives selected by prescribers. For example one of my own patients saved $50/month for my switching from doxycycline tablets to capsules. Go figure.
And a new RTBT ukulele song!
Fun fact, thanks to my daughter Ann-Claire Lin for the initial song title, song selection and first draft of lyrics. Not many daughters would listen to dad and help write an RTBT ukulele tune. Thanks AC!
