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Impact of Real-Time Benefit Tools on Patients’ Access to Medications: A Retrospective Cohort Study

      High out-of-pocket prescription drug costs can lead to patient nonadherence and poor health outcomes.
      • Mojtabai R
      • Olfson M.
      Medication costs, adherence, and health outcomes among Medicare beneficiaries.
      • Khera R
      • Valero-Elizondo J
      • Das SR
      • et al.
      Cost-related medication nonadherence in adults with atherosclerotic cardiovascular disease in the United States, 2013 to 2017.
      • Doshi JA
      • Li P
      • Huo H
      • Pettit AR
      • Armstrong KA.
      Association of patient out-of-pocket costs with prescription abandonment and delay in fills of novel oral anticancer agents.
      • Goldman DP
      • Joyce GF
      • Zheng Y.
      Prescription drug cost sharing: associations with medication and medical utilization and spending and health.
      • Cohen RA
      • Boersma P
      • Vahratian A.
      Strategies used by adults aged 18-64 to reduce their prescription drug costs, 2017.
      • Fendrick AM
      • Buxbaum JD
      • Tang Y
      • et al.
      Association between switching to a high-deductible health plan and discontinuation of type 2 diabetes treatment.
      One component of this problem stems from our complex system of prescription drug pricing; medical providers do not know the cost of the medications they are prescribing.
      • Sloan CE
      • Millo L
      • Gutterman S
      • Ubel PA.
      Accuracy of physician estimates of out-of-pocket costs for medication filling.
      Accordingly, clinicians may unwittingly order expensive medications that their patients struggle to afford. When faced with such prices, patients may decline to pick up medications from their pharmacies. For some, this may result in a delay in care as prescribers attempt to identify and prescribe affordable alternatives. Other patients may be left with limited or no access to needed medication.
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      3. NCPDP. Standards matrix. Available at: https://ncpdp.org/NCPDP/media/pdf/StandardsMatrix.pdf. Accessed July 6, 2021.

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