Can patients look up any drug or are they restricted to researching drugs they have already been prescribed?

XMLWordPrintableJSON

    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • US CARIN Real-time Pharmacy Benefit Check (RTPBC) (FHIR)
    • Pharmacy
    • Table of Contents
    • Overview
    • Hide

      Clarify in the implementation guide that there are two anticipated use cases for RTPBC exchange: (1) to receive specific cost and coverage information for a medication the patient has already been prescribed, and (2) to explore potential costs for one that hasn't yet been prescribed.

      Content to be included in a new Usage Context section on the Use Cases page of the IG:

      Usage context
      The real-time pharmacy benefit check is designed to provide accurate cost information based on the specifics of a patient prescription. Details such as the specific drug name, dose form, strength and quantity must match the prescription exactly in order to receive reliable results.

      However, a patient may wish to use the process for a medication they haven't yet been prescribed, for example to understand its cost compared to their current treatment. In that circumstance, the results must be viewed as approximate information that may not reflect their actual cost when their prescriber has ordered a particular product and dosage.

      Show
      Clarify in the implementation guide that there are two anticipated use cases for RTPBC exchange: (1) to receive specific cost and coverage information for a medication the patient has already been prescribed, and (2) to explore potential costs for one that hasn't yet been prescribed. Content to be included in a new Usage Context section on the Use Cases page of the IG: Usage context The real-time pharmacy benefit check is designed to provide accurate cost information based on the specifics of a patient prescription. Details such as the specific drug name, dose form, strength and quantity must match the prescription exactly in order to receive reliable results. However, a patient may wish to use the process for a medication they haven't yet been prescribed, for example to understand its cost compared to their current treatment. In that circumstance, the results must be viewed as approximate information that may not reflect their actual cost when their prescriber has ordered a particular product and dosage.
    • Scott Robertson / Frank McKinney : 15-0-0
    • Clarification
    • Non-substantive
    • 0.1.0

      Will this resource only be available for drugs that the patient has already been prescribed or will patients be able to investigate the cost of other drugs not yet prescribed? Based on the language of the overview it seems like it is just for drugs the patient has already been prescribed, but other sections seem to imply that patients can search for any drug. Think that should be more clearly indicated if there are limits as to what patients can search and not search. This is an important point, as the patient would need to know the correct dose and quantity to accurately price the drug. Without an existing prescription, it is going to be very difficult for patients to accurately make drug, dose, and quantity selections.

      Existing Wording:

      Using RTPBC, a patient can learn the cost and insurance coverage related to medications they’ve been prescribed.

            Assignee:
            Unassigned
            Reporter:
            Celine Lefebvre
            Celine Lefebvre
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: