Last week’s move by a federal judge to halt the Trump administration’s drug-price transparency rule means that, for now, pharma companies won’t be required to include costs in TV drug ads. But electronic health records are already being used to convey this kind of information, and could become a more viable channel in the future.
“Cost-consciousness is part of what it means to be a professional, and if you’re going to be an advocate for your patients, that also means you’re going to be an advocate for their wallet,” said Brian Miller, a researcher at Georgetown University who has studied the benefits of including cost information in the EHR.
“I’d argue that the world has changed and part of the physician’s responsibilities is to help their patients manage the costs,” Miller said.
Many EHRs already disclose the expense of procedures and treatments, although it’s not yet a comprehensive listing. An article Miller and colleagues published in Journal of the American Medical Association last Friday argues in favor of including medical-procedure prices within the EHR.
The authors base this assertion on two studies. In one 2013 study, physicians who were shown the prices of diagnostic and laboratory test fees in their health system’s electronic medical record decreased their use of these tests by 8.6%.
Another study, this one conducted in 1990 within a primary care setting, showed that when physicians were provided the prices of these tests via an EHR, they ordered 14.3% fewer tests overall, leading to a decrease in charges to the patient.
When asked about the current state of EHRs and their role in sharing such data, Miller said, “Right now it’s the equivalent to shopping in a grocery store without prices. You can just buy, but when you get to the checkout line, you have no idea of what the cost is.”
This is often a source of frustration for patients. The price for healthcare services plays a large role in the medical decision-making process. Including prices in EHRs would not only make this process less stressful, but would also be a major and necessary step forward for patient-physician relationships, Miller said.
A few vendors that work in the EHR space are starting to innovate the traditional format and are moving toward inclusion of financial information, observed Hudson Plumb, SVP of EHR and outcomes optimization at the agency Heartbeat.
Angelo Campano, VP of the point of care practice at Ogilvy Consulting, which he said represents about 75 different brands, named Novo Nordisk, Bayer and Janssen (not all of which are Ogilvy clients) as being somewhat ahead of the curve in terms of including drug-price information, but the companies have only been able to do it with certain medicines or within EMRs from certain medical systems.
Furthermore, Campano stated, of the healthcare companies that do participate, by and large, they aren’t yet realizing the full potential of these systems. Of the brands his agency works with, most are “only using the EHR for 1% of its capability. They’re still using EHR for its most basic functions.”
One way to get pharma brands to leverage this channel further, he suggested, is by getting their legal teams more educated and comfortable with how the platforms work. Alongside this education, experimentation is crucial for the evolution of EHRs.
The conversation about price transparency and its relationship with EHRs is likely to continue to move forward alongside changes to their format.
Said Miller, “Drug transparency is going to come. It might come this year, it could come several years from now. And when it comes, we need to be prepared to explain the value of products and services in more clear and concrete terms.”