How Technology Can Improve Health Outcomes

Health plans and formularies can create issues for physicians trying to best treat their patients. These problems can interfere with workflow process and delay very important treat for individuals in need of care. Here is how eNavvi is trying to combat them to not only save physicians time and money but to also improve health outcomes of the public.

1. Doctors do not have quick or easy access to formulary information

A study has shown only 33% of physicians report usually or always being aware of patient’s formularies. 20% of physicians report being usually or always aware of patient’s out-of-pocket costs for medications.

This is particularly challenging for physicians attempting to reduce costs for their patients through prescribing lower cost alternatives as one study found formulary coverage often has considerable variability over just a 2 year time period. There can also be variability in status, with more than 60% of drugs preferred on 2 to 4 of the 6 formularies studied.

2. Exclusion of evidence-based treatments

Antipsychotics and Medication-Assisted Treatment (MAT) for substance abuse disorders are the most commonly excluded from formularies. As of 2013, only 28 of the 50 states covered all three FDA-approved drugs for opioid addiction within their Medicaid programs; even though these drugs have been shown to reduce drug use, lessen disease rates and reduce criminal activity.

3. Cost-sharing requirements

It has been found that low income individuals without disabilities ages 19-64 covered by Medicaid spent an average of 2.4% of their income on out-of-pocket costs on medical treatment in 2002. Compared to privately insured, not low income individuals who spent a third less (0.7%) on medical expenses.

For low income individuals, higher copayments correlate to reduction in medication use or medical care leading to poorer health and use of high-cost services e.g. emergency centers.

High copayments also correlate with drug noncompliance. A study analyzing data of 114,232 patients found that patients with a $5 copayment had a 95% compliance with their antihypertensive medications. While those with a $20 copayment were 76% complaint and those with a copayment between $21 and $165 were only 48% compliant.

eNavvi is solving this through their formulary database. The database includes information such as drug cost and coverage information. The goal of this is to provide as much information to doctors so they may make the most educated decision when prescribing medication to their patients.