Impacts of a Physician-targeted Price Transparency Tool on Medication Out-of-pocket Costs

NCT04940988 | Completed

• 1 other identifier: QI-RTPB
• Study Type: observational
• Target: 21,401
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to evaluate whether presenting patient out-of-pocket cost information to the provider at the time of prescribing leads to orders for medications with lower out-of-pocket costs. The Real-Time Prescription Benefits (RTPB) tool has been implemented to randomly selected providers across NYU Langone Health's outpatient physician practices. The RTPB tool provides physicians with information about patient out-of-pocket (OOP) cost for medications at the point of outpatient prescribing. OOP is inclusive of any copay, coinsurance, and deductible that the patient owes given their prescription drug benefit plan. If the physician is submitting a prescription order and a clinically-appropriate alternative with a lower OOP cost is available, an alert with OOP cost information for the drug being initially ordered as well as up to three lower-cost alternatives will be displayed. Implementation of this tool will be analyzed to see if it will lead to reduced out-of-pocket costs on ordered medications when alternatives were available. Because effects could vary along many dimensions (e.g., specialty, drug class, insurance type), secondary analyses will be conducted and stratified along such dimensions. Analyses will be conducted at the prescription order level.

Conditions

Prescriptions; Costs and Cost Analysis

Outcome Measures

Primary Outcomes (1)

• Medication out of pocket cost per day

  The primary outcome, which will be measured at the medication-order level is out-of-pocket cost per day for a drug ordered. It will be computed by dividing the out-of-pocket cost of a drug by the days supply. Data will be collected through the electronic health record.

  Through study completion, an average of 1 year

Secondary Outcomes (2)

• Whether an order was placed for a mail-order pharmacy

  Through study completion, an average of 1 year

• Days supply

  Through study completion, an average of 1 year

Study Arms (2)

See alert

The intervention group refers to medication orders placed by prescribers when practicing in an outpatient department randomly assigned to receive the intervention, which is implementation of the RTPB tool.

Other: Real-time benefits check

Do not see alert

The non intervention group refers to medication orders placed by prescribers when practicing in an outpatient department randomly selected to not receive the intervention.

Interventions

Real-time benefits check OTHER

Prescribers practicing in outpatient departments assigned to the intervention arm will be shown popup alerts with their patient's insurance benefit design-specific out-of-pocket cost for the drug being ordered as well as out-of-pocket costs for up to 3 lower-cost alternatives if available. Alternatives will only be shown when available and when the patient and his or her benefit design information can be matched by the electronic health record system to accurately query out-of-pocket cost information.

Also known as: Physician-focused medication price transparency

See alert

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The intervention group refers to medication orders placed by prescribers when practicing in an outpatient department randomly assigned to receive the intervention, which is implementation of the RTPB tool. The control group refers to medication orders placed by prescribers when practicing in an outpatient department randomly selected to not receive the intervention.

You may qualify if:

• Medication orders for which this match and query was successful and outcomes data was available.

Sponsors & Collaborators

• NYU Langone Health: lead

Study Sites (1)

NYU Langone Health

New York, New York, 10016, United States

Location

Related Publications (1)

• Desai SM, Chen AZ, Wang J, Chung WY, Stadelman J, Mahoney C, Szerencsy A, Anzisi L, Mehrotra A, Horwitz LI. Effects of Real-time Prescription Benefit Recommendations on Patient Out-of-Pocket Costs: A Cluster Randomized Clinical Trial. JAMA Intern Med. 2022 Nov 1;182(11):1129-1137. doi: 10.1001/jamainternmed.2022.3946.

  PMID: 36094537 DERIVED

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 18, 2021
• First Posted: June 28, 2021
• Study Start: November 18, 2020
• Primary Completion: July 30, 2021
• Study Completion: July 30, 2021
• Last Updated: September 16, 2021

Record last verified: 2021-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)