4 Pharmacy Insights for 2024

If we could look into a crystal ball for 2024, what would we see for pharmacy? Miranda Rochol, SVP of Provider Solutions at Prescryptive Health, shared her views in a wide-ranging discussion.

Prescription reimbursement is changing

I think from a prescription reimbursement perspective, that is a continuous struggle. There’s lots of new models like say, a direct to employer pricing model where employers and pharma manufacturers come together on a network to offer competitive pricing that may help pharmacists.

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It’s interesting, but there’s actually a direct correlation between prescription cost and adherence. According to a 2020 report by IQVIA, the prescription abandonment rates are less than 5% when the prescription carries a zero co-pay but jump to 45% when the cost is over $125 and 60% when the cost is more than $500. Imagine if we’re able to empower the patient to see that before the pharmacy gets the prescription and see if there’s other options for that patient to pay and cover that expense.

And then if it’s all integrated into the pharmacy system and the patient’s mobile experience, which we all have one in our hand every day. Everybody will benefit from that additional transparency and that care coordination. That’s really what patients want. That is what we want when we want to be consumers of our own health care.

…an AI model for patients … could help increase reimbursement for the pharmacy, could increase adherence for the patient, and potentially help increase the pharmacy profits.

Miranda Rochol, SVP of Provider Solutions

And changes to DIR fees mean maximizing your cash business now

The first three months of the year, it’s very likely that the pharmacies will be paying the dealer fees that they were retrospectively charged from 2023. So the cash flow problem for the pharmacy is, especially in the beginning of 2024, is going to be extremely challenging. However the changes will also force increased transparency in the PBM industry. And all of us know that we want more transparency around that industry. So ultimately the changes that are coming will be good. It’s just going to be hard for us to get there.

New technology like digital prescriptions offer opportunities for pharmacists

Let’s go back in history. Twenty years ago, patients were given their prescriptions as a piece of paper. Some of us remember it maybe a little bit better than others. But we evolved and introduced electronic prescribing, and we thought that that would actually solve medication adherence. We thought it might help in how much time it takes to fill a prescription.

I remember in the early 2000 when I was working at a pharmacy, a patient would drop off their piece of paper and we would tell them it be 30 minutes, 60 minutes, tomorrow. But that was an immediate interaction that the patient could understand. They also would be able to understand the price because I would be processing the prescription right in front of them.

But when electronic prescribing was introduced, we lost that interaction. We removed the patient from the process and that had unfortunately a different impact to the overall care experience for that patient.

So I think the technology I’m most excited for is technology that empowers the patient to become the consumer of their health care, of their prescriptions. And with that patient-first technology, pharmacies will likely get more patients, and those patients will be more empowered.

So technology that empowers the patient to be more educated about their prescription before the pharmacy receives and fills it means the pharmacy staff can be more efficient while still offering that best-in-class patient care.