How to Become a Prescription Savings Specialist

MAY 24, 2016
Given that various certifications are currently advocated as a means to expand pharmacists’ professional expertise, I’d like to suggest a new type of title: the prescription savings specialist.

This title doesn’t come with a fancy diploma or approval from a national certification board. However, it does offer the satisfaction of knowing that many patients will appreciate your efforts and adhere to medications they might not otherwise be able to afford.

With co-pays and deductibles always increasing, pharmacies have an opportunity to work with patients and providers to help reduce medication costs. Therefore, a prescription savings specialist is an expert on using all available programs and tools to help make medications more affordable.

Who can become a prescription savings specialist?
While a pharmacist is the ideal choice to drive this initiative, it can also be managed effectively by an experienced and interested pharmacy technician. At the very least, it needs to be someone who’s comfortable with how retail pharmacy works.

Very few individuals working outside the pharmacy understand how the pharmacy processing and co-pay system works. Besides, pharmacy claims and co-pays can be confusing.

Here’s what becoming a prescription savings specialist requires:

1. Heightened awareness of patient co-pays.
As a front-line dispensing pharmacist, I know how easy it is to completely ignore co-pays. It’s hard enough to make sure the right patient is getting the right medication with the right directions, and that it doesn’t interact with anything else the patient might be taking. I’m checking dates of birth, age, and dosages while doing a drug utilization review and managing a host of errors that creep into the written prescription. 
Being prescription savings specialist requires focusing on co-pays, too. You’ll need to consider whether the co-pay appears unusually high, based on what the patient typically pays, and decide whether the patient should be called about it.

2. Knowing how plan co-pays and tier structures work. 
When confronted with a $100 co-pay, the prescription savings specialist would have to immediately begin asking questions like, “Are there other clinically similar products available?” I’d like to think a prescriber would naturally prescribe a relatively inexpensive generic, but sometimes, patients may have pushed for the more expensive drug, not realizing they were going to face a high co-pay in doing so.
At that point, the prescription savings specialist would need to determine the appropriateness of other options and their costs by either calling the health plan or running some test claims. Of course, this would also involve some conversations with the patient and the provider, but the results could be rewarding.

Jason Poquette
Jason Poquette
Jason Poquette, RPh, is a 1993 graduate of the University of Connecticut School of Pharmacy. For most of his career, he has held retail pharmacy management positions. He also spent 7 years working in health plan formulary analysis and research. He currently works for Pharmacy Healthcare Solutions (PHS) as manager of an outpatient hospital pharmacy, developing programs to improve utilization of the pharmacy and transitional care for patients.