Real-time benefit checks (RTBC) have finally become a reality in 2023. To explain, RTBCs are a technology that displays a patient’s personalized out-of-pocket price for a specific drug and dose in the electronic health record (EHR) at the point of care.

In response to Congressional mandates, the Centers for Medicare & Medicaid Services (CMS) mandated that Part D plan sponsors must adopt one or more real-time benefit comparison tools to enable consumers to compare their out-of-pocket costs for specific drug brands before they pick up their drugs at the pharmacy. CMS also mandates prescribers to have the same real-time benefit comparison tools to see patient-specific drug pricing information at the point of prescribing.

The goals are to improve medication adherence, reduce prescription drug costs, and, most importantly, bring about price transparency within the healthcare industry.

We have introduced the Real-Time Benefit Checks: What Account Managers Should Know microlearning module to help equip account management teams with the most prevalent information on the impacts of the new RTBC mandate on prescribers and customers.

Real-Time Benefit Checks: What Account Managers Should Know gives an overview of how patients and prescribers can use real-time benefit checks. Most importantly, account management professionals will receive insights about the ways these tools are affecting market access and driving hardball negotiations between manufacturers and health plans.

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How can physicians use RTBCs?

These tools can be integrated into a provider organization’s electronic health record (EHR) so that prescribers have real-time access to drug costs and other information while they are seeing patients. RTBCs enable prescribers to improve and enhance communication with patients.

How can patients use RTBCs?

Part D health plans typically use tiered formularies outlining different levels of cost-sharing for patients. Real-time benefit checks are a great asset for patients to “shop” for lower-cost alternatives to brands their providers prescribe.

As a result, RTBCs are great for both patients and prescribers, as they can more easily explore alternative drugs with lower out-of-pocket costs. Furthermore, providers can use this technology to prescribe drugs that don’t need prior authorization, ultimately saving time; doing so puts greater pressure on pharma manufacturers to contain drug prices.

Make Real-Time Benefit Checks: What Account Managers Should Know course a part of your pharmaceutical sales training and account management training programs. Click here to chat with our training expert.

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