Price Transparency Is Not the Same as Affordability and Adherence - Report - MDSpire
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Understanding the Distinction Between Price Transparency, Affordability, and Medication Adherence

  • By

  • Catherine S. Hwang

  • Michael A. Steinman

  • October 5, 2026

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Understanding the Distinction Between Price Transparency, Affordability, and Medication Adherence

Overview

Real-time benefit tools (RTBTs) are increasingly integrated into clinical workflows to provide patient-specific medication cost information. Limitations such as inaccurate cost estimates and lack of comprehensive education for clinicians persist.

Background

The integration of RTBTs into electronic health records aims to enhance patient care by providing real-time cost information and alternatives at the point of care. Understanding the limitations of RTBTs is crucial for addressing challenges in medication access and adherence.

Data Highlights

No numerical data available in the source material.

Key Findings

  • RTBTs are designed to present patient-specific out-of-pocket medication costs and suggest lower-cost alternatives.
  • Some studies show RTBTs reduce out-of-pocket expenses and improve medication fill rates, while others report no significant impact on overall medication dispensing.
  • Clinicians express a need for more education regarding RTBTs and their functionality.
  • RTBTs may provide inaccurate or incomplete information, leading to mistrust among clinicians.
  • Medication adherence is influenced by multiple factors beyond cost.

Clinical Implications

Clinicians should be aware of the limitations of RTBTs and engage in discussions with patients about medication affordability and adherence.

Conclusion

RTBTs do not address the underlying issues of medication affordability.

Related Resources & Content

  1. Sloan et al., Journal of General Internal Medicine, 2023 -- Understanding RTBTs in Clinical Practice
  2. the medicine maker — Staying Connected
  3. JAMA Network Open — User-Directed vs Interruptive Real-Time Benefit Tools for Medication Changes in Primary Care
  4. Journal of Medical Internet Research — Integrating Dispensing Information with Electronic Health Records: A Guide to Accessing Commercial Pharmacy Databases for Comprehensive Quality Enhancement
  5. optometric management — When Price is a Concern
  6. User-Directed vs Interruptive Real-Time Benefit Tools for Medication Changes in Primary Care
  7. HTI-4 Overview and Key Dates for Certification Program - ONC
  8. Prescription Use and Spending After the Introduction of a Real-Time Prescription Benefit Tool | Clinical Decision Support | JAMA Network Open | JAMA Network
  9. Final CY 2025 Part D Redesign Program Instructions Fact Sheet | CMS

Original Source(s)

Price Transparency Is Not the Same as Affordability and Adherence

  • by Catherine S. Hwang, Michael A. Steinman

  • October 5, 2026

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