this post was submitted on 12 Jul 2024
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I'm in my third year of medical school, so I've just started my clinical rotations, but one of the things that shows up on almost every reference table for physicians regarding treatment options is information on the price for the patient. I'm rotating in a family medicine clinic right now, and we pretty frequently prescribe the best possible treatment, and then when the pharmacy runs it through the patient's insurance and finds out how much it's going to cost, we then start working down the list of next-best alternatives until we can find something the patient can afford. Because there are so many different insurance plans out there, we have no idea how much something is going to cost until the insurance tells us.
I understand that you donβt have the information. But the information is retrievable, just with way more delay than we need.
Each time I talk to you, to get a new prescription for the next-best thing, it costs me about $100.
If we could get all the information systems good enough, you could prescribe, insurance could quote, and you could re-prescribe in seconds.
Unfortunately, most health insurance plans have a separate sub-company manage the pharmacy benefits and we have absolutely zero way of accessing their systems. It would be lovely if we could see what your insurance would cover immediately as we prescribe it, but that also runs into the problem of us not having any control over the actual pharmacy and their billing and pricing.