By Elizabeth Helms
Capitol Weekly
As health care delivery evolves thanks to advances in data sharing and technology, it’s important that health systems harness the availability of these new tools to improve transparency, information dissemination and communications between doctor and patient, allowing them to better work together to make vital health decisions.
Assembly Bill 2352, introduced by Assemblymember Adrin Nazarian and sponsored by the California Chronic Care Coalition, is important legislation that will provide these critical connections.
The bill, known as the Patient Rx Information and Choice Expansion Act (PRICE Act), will make prescription drug cost and utilization information electronically available to physicians at point-of-care so they can relay it to patients upon prescribing medications, whether in-office or via telehealth appointments.
AB 2352 will bring much-needed transparency to the patient, provider and insurer relationship. It will allow providers and patients to access to real-time information including the patient’s eligibility for the medication, a full list of medications that are covered by their insurer, cost sharing information based on dispensing pharmacy type, and information on whether the patient is required to try and fail on certain types of medications for their condition before they can access a medication their doctor recommends.
The Kaiser Family Foundation found in 2019 that 29% of Americans do not take their medications due to high costs.
AB 2352 is needed because unfortunately, patients are often forced to make decisions about their health care based on what they can afford.
When prescribed a medication, patients generally do not know the cost of the treatment until they get to the pharmacy counter where they can be blindsided by unexpected out-of-pocket costs, often hundreds of dollars each month. When patients can’t afford to pay for their medications, they get sicker, resulting in much higher personal and medical costs down the line.
If doctors have prescription cost information available when they discuss treatments with patients, they can determine how best to navigate the patient’s health in light of high-cost medications.
This can mean informing patients about free and discount medication programs, or adjusting their treatment to something they can afford. In absence of this information, physicians often have no idea whether their patients can’t access the medications they need, and often don’t know that patients forgo prescribed care because it’s too expensive.
AB 2352 will also reduce the administrative burden on pharmacists routinely spend a good deal of time explaining costs and options to patients, and often take on the responsibility of helping patients figure out how they can afford prescribed treatments.
Patient’s inability to afford medication is no small issue.
The Kaiser Family Foundation found in 2019 that 29% of Americans do not take their medications due to high costs and a 2020 survey found that 44% of low-income Americans skip prescribed medications due to cost[1]. While work is being done to try to bring down the costs of health care, AB 2352 is a critical step toward empowering physicians with the information they need to make sure patients can access the treatments they need and can afford.
At a time when patients are already struggling financially due to skyrocketing inflation, the last thing they need is to be hit unexpectedly with high costs at the pharmacy counter, where they have no ability to discuss their options with their doctor.
AB 2352 will bring more transparency to health care providers and patients and help ensure patients have access to affordable medications so they can adhere to treatments their physician prescribes. AB 2352 will improve the quality of and access to health care and the legislature and governor are strongly encouraged to approve it.
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Editor’s Note: Elizabeth Helms is the president and CEO of the California Chronic Care Coalition, an alliance of nonprofit, social consumer and provider organizations.