AN EASIER PILL TO SWALLOW?
Bay State co. eyes remedy to high health costs
Leaders of Southboro-based RxAdvance say their prescription management system could save state Medicaid funds by cutting unnecessary meds for chronically ill patients — one of the major drivers behind skyrocketing pharmaceutical costs.
“These are people living with obesity, Type 2 diabetes, asthma, hypertension,” said John Sculley, a former Apple CEO who is RxAdvance’s chief marketing officer. “This is what’s killing the health care system from a cost standpoint.”
RxAdvance works with insurance companies and state Medicaid plans to bring an exhaustive list of patient prescriptions into one accessible electronic location.
The platform works by bringing together the mishmash of electronic patient records that were developed across health care systems as a requirement under Obamacare.
The result, Sculley said, gives doctors a quick and easy way to discover costly pharmaceutical snags created under the complicated guidance of multiple specialists: repeat prescriptions, medications with overlapping effectiveness or even incompatible drugs that create new medical issues.
“There’s almost always duplication in what is being prescribed for chronic care patients,” Sculley said. “It’s a population that has made it virtually impossible for politicians to come up with a health care solution that can be sustainable.”
The 60-person company opened in 2013 and serves a handful of states, including Ohio and South Dakota. But an expansion is underway, including the addition of 2,000 employees, and there are plans to bring its services to the Bay State.
“You have about 1.6 million Medicaid lives in the state of Massachusetts,” said Ravi Ika, president and CEO of RxAdvance. “There’s a significant opportunity there to manage services.”
Sculley and Ika added the technology could help fill the Medicaid gap if the GOP successfully shifts more of the financial burden to states.
And although the company was started four years ago, it is just now starting to see rapid growth. About $63.5 million in revenue was generated in 2016. The projected revenue for this year is around $500 million.
Studies have shown that many medications for chronic illnesses are wasted — 50 percent of those drugs are not taken as prescribed.
Prescription drug costs accounted for a whopping one-third of cost growth for Massachusetts in 2015, according to the most recent analysis of state health care expenses.
“This is an industry that hasn’t changed its technology much in the last several decades,” Sculley said. “This brings transparency to the whole medical cost area.”