How Real-Time Benefit Check Can Improve Prescriber Decision-Making and Treatment Uptake


Michael Burger, senior consultant at Point-of-Care Partners, explains that real-time benefit check lets physicians know how much a drug will cost the patient at the time they're writing the prescription, allowing them to give the patient a treatment they know they can afford.

At AMCP 2023, Michael Burger, senior consultant at Point-of-Care Partners, explained the important role real-time benefit check (RTBC) plays in the decision-making process.

What is real-time benefit check?

Real-time benefit check—also known as RTBC—is an electronic transaction, which is used to identify a patient's prescription benefit coverage and to identify what their out-of-pocket costs will be, as well as what any of the restrictions on that prescription might be, things like prior authorization. RTBC is available to the prescriber. So in the doctor's office at the point where the prescription is being written, information about what that prescription will cost the patient is available and it can be used as part of the decision making process to decide which drug to order for the patient.

How does RTBC encourage providers to consider costs when prescribing medications?

Prescription cost is something that is not especially transparent, it isn't uncommon for the patient to understand what the prescription will cost only when they get to the pharmacy counter. So sometimes that results in the patient not being able to afford the medication, or maybe being forced to pay for the medication and then not use it according to instructions. Maybe they cut a pill in half or they take it every other day.

So the idea behind RTBC is that the cost to the patient is known to the physician at the point where they're writing the prescription, so they can decide on the most cost effective drug, one that they know that the patient can afford, so that way they're sure that the patient gets on the therapy.

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