Telemedicine Prescription Cost Effect on the Pharmacy Benefit

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

As a company whose main priority is to stay on top of the latest news and drivers of pharmacy cost, we find it increasingly important to discuss the increase in prescription drug utilization effect that the telemedicine market is predicted to have on pharmacy benefit costs, which is one reason why so many chain pharmacies are getting actively involved in offering telemedicine services.

For those of you who are unfamiliar with the term, the American Telemedicine Association defines telemedicine as the "use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status." Directly related to this term are "telehealth" and "teladoc," which also revolve around the idea that health professionals and services can be accessible to patients through electronic mediums rather than just face-to-face and have the ability to prescribe drugs as a solution to the described patient illness.

In recent news, there have been several pieces of legislation proposed regarding the extent to which telemedicine can be applied. For example, two United States Senators just introduced a bill that would permit health professionals working in Veterans Affairs (VA) facilities to treat their patients using the technology that is associated with telemedicine, regardless of the state. Additionally, this past summer Delaware introduced a new law that outlined how telemedicine can be practiced within its borders.

That being said, it is important to carefully analyze how prescription utilization (number of prescriptions for each person) is going to increase as many carriers begin to expand their use of telemedicine. Walgreens and MDLIVE, for example, recently began offering telehealth services in three new states, with the expectation that 25 states will have access to them by the end of 2015. Part of their offering is that remote doctor access is available for just $49.00 a visit. Additionally, CVS announced this past summer that they will be working closely with telehealth companies American Well, Doctor on Demand and Teladoc to make telemedicine programs more available to patients. 

With all of these changes taking place, one must be prepared for an increase in the number of prescriptions written since telemedicine services are much easier to access than making an appointment with patients' primary care doctors. As a result, entities providing pharmacy benefit services to their members or employees need to benchmark, not only the date that they offer telemedicine services, but also the prescription utilization to see how such utilization changes/increases as compared to when telemedicine services were not available. All PBIRx client profiles document if the telemedicine services are offered, by whom and on what effective date so that our analysts can better understand prescription utilization increases, which is a pharmacy benefit cost driver.

For more information about the telemedicine market and how your pharmacy benefits may be affected by its growth, please give us a call at (888) 797-2479. Additional information about how we can help you with your pharmacy benefits can be found at www.pbirx.com.