Ochsner Health Network Prescribers Save Patients More Than $5.1 Million

Since 2021, Ochsner Health Network physicians have saved their patients more than $5.1 million in pharmaceutical copays using the Real-Time Pharmacy Benefits tool embedded within Epic. This digital tool alerts physicians if a lower-cost alternative to a patient’s prescribed medication is available.

“With Real-Time Pharmacy Benefits, prescribers can see the cost the patient will pay out of pocket when they pick up their medication at the pharmacy,” says Matthew Malachowski, PharmD, MHA, BCPS, System Director of Population Health and Ambulatory Care at Ochsner Health Pharmacy. “This is not an estimator tool. It is the actual contract price the patient can expect to pay for this medication with their current insurance at the selected pharmacy.”

The alert helps prescribers identify generic and brand-name prescription drugs covered by the patient’s health insurance plan. If a similar product is available at a lower patient cost, an alert pops up in Epic when the provider orders the original medication. The pop-up displays the alternative product’s name and required copayment.

Highlighted medications are in the same therapeutic class but available at a lower cost to the patient, typically because they fall within a preferred formulary tier. If this alert appears while the patient is in the room, a physician can discuss the benefits of each medication as well as their costs, reducing the chance of sticker shock or even prescription abandonment at the pharmacy counter.

“Using Real-Time Pharmacy Benefits has transformed my practice,” says Lee Montgomery, MD, a family physician in Baton Rouge. “It’s easy to use and patients appreciate the effort to make their care more affordable. I highly recommend adding this tool to your practice to boost patient satisfaction and improve outcomes,” says Dr. Montgomery.

This program is live across Ochsner Health’s instance of Epic for all facilities, partners and prescribers.

“We understand not all recommendations are exactly what the prescriber is looking for, but with incremental increases in utilization, patient savings will increase exponentially,” says Dr. Malachowski. “Our current acceptance rate—the rate at which prescribers accepts the alternative drug recommendation via the Epic alert—is 20% systemwide,” says Dr. Malachowski. “We would like to see that grow to 25%.”

As for Dr. Montgomery, his acceptance rate is 39%, which accounted for 92% of total possible savings (the remaining recommendations were associated with very low-level discounts on alternatives). “I love being able to tell my patients that they can get the same effective medication at a fraction of the cost,” says Dr. Montgomery.

Note: A recent Epic upgrade has slightly impacted the tool, creating some ambiguity in the information that is displayed. Currently, Epic displays a medication’s active ingredient only. In some cases, the provider will see the same active ingredient and dosage, with one at a lower cost. For instance, epinephrine 0.3 mg is shown twice instead of EpiPen versus Auvi-Q, which would save a patient $50. The tool remains functional, and the Real-Time Pharmacy Benefits team is working to improve that specificity.