Texas Health Aetna Hopes to Reduce Drug Costs Through Data and Education

Texas Health Aetna’s new campaign hopes to educate physicians on inexpensive versions of drugs to reduce healthcare costs across the board.

Called Go-to Green, the health insurance provider is using data to find cheaper prescription options. Texas Health Aetna’s Chief Medical Officer Dr. Delanor Doyle says that the company utilizes data from Texas Health Resources and Aetna to find out what drugs are being prescribed by which physicians and to whom in their netowrk. If they are aware of a medicine that is equally effective and cheaper, they will contact the physicians and let them know about the more inexpensive options.

Doyle says the doctors are often unaware of the costs of the drugs, and receive their information about prescriptions from the pharmaceutical representatives, who are incentivized to offer up the more expensive options and are coached to not discuss the price. “The pharmaceutical companies don’t want the doctor to know the cost, and the doctor is not focused on it,” Doyle says.

Doyle says that while patients may not see the savings directly because the insurance may cover the cost of the medicine, if the doctors are prescribing more expensive medicines then the insurance company’s costs go up. Eventually, those costs are passed on to consumers via insurance premium hikes.

“Everybody ends up paying as costs go up,” Doyle says.

Doyle highlighted Metformin, a diabetes medication, that can cost up to $6,000 for a 30 day dose. Another version of basically the same medication, called Glucophage, costs around $50 for a month’s supply. The Go-to-Green campaign educates physicians about the more inexpensive option to reduce health costs overall.

“Our goal is to take care of the members and bend the cost curve,” Doyle says.

Texas Health Aetna is an independent insurance provider and collaboration between Texas Health Resources and Aetna, and is meant to be a more mobile and innovative insurance carrier that says it can find cost savings where insurance behemoths like Aetna and Blue Cross Blue Shield can’t.