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Decision support can guide clinicians to prescribe lower cost alternatives

Minor differences in co-payments sometimes mask exponential differences between similar generic formulations.

Susan Morse, Senior Editor

To curb costs in prescription drug spending, clinical decision support can help stop the upward trend of per capita spending that makes cost in this country higher than in any other industrialized nation.

Adam Szerencsy, Medical Director, Ambulatory Informatics, NYU Langone Health will discuss how the health system was able to reduce its medication costs, at HIMSS19.

NYU Langone drove clinicians to lower cost-equivalent medications in the ambulatory setting by first identifying medications that were contributing to its overall prescription drug spend across the ambulatory network.

"Data and analytics are key," Szerencsy said. "We analyzed the payor data and prescribing patterns from our shared savings programs to identify medications that were contributing to our overall prescription drug spend across the ambulatory network, including per member, per month costs and generic utilization rates. This helped us focus on which medications to target."

Once the interventions were deployed, monthly reports were used to track acceptance rates for lower cost alternatives.

"By developing clinical decision support tools coupled with behavioral economics principles we were able to recommend lower cost therapeutic alternatives to providers during order entry within the EHR," Szerencsy said.

This doesn't mean it was easy.

The prescription drug market and supply chain is extremely complex with a multitude of stakeholders, entangled relationships and very little transparency around true costs, Szerencsy said. 

It is also critical to ensure that alternative recommendations are carefully vetted, that similar dosing regimens are maintained and incentives are aligned to attain maximum benefit.

Most clinicians and patients have very little insight into medication costs other than minor differences in co-payments. But, in some cases, there are exponential differences even between similar generic formulations, according to Szerencsy.

Adam Szerencsy, medical director, Ambulatory Informatics, NYU Langone Medical Center, will speak from 10-11 a.m., Thursday, Feb. 14, Romm W311A, at tee Orange County Convention Center, during HIMSS19 in Orlando, Florida.

Twitter: @SusanJMorse
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