Rx-decision: A decision support tool for the optimal prescription drug plan for patients

The healthcare system in the United States is undergoing changes aimed at affordable care, but the complexity of the healthcare industry prevents patients from making optimal healthcare and insurance decisions, and achieving the full potential of healthcare reform. As a consequence of healthcare reforms, digital medical records have facilitated the widespread availability of publicly available, statistical data. Feeding the pool of expanding data is the patient-doctor interaction; averaging twenty minutes, physicians assess the patient's complaint and prescribe a course of action. Pharmaceutical and insurance companies work together to build suitable products for consumers. The intricate relationships in the healthcare industry exacerbate the runaway healthcare costs facing the American public. The data collected provides the basis for a decision support tool for patients to compare and rank Medicare Part D Prescription Drug Plans based on a patient's individual situation and preferences. The tool will provide explicit information that will assist the patient in determining the most suitable prescription drug plan, taking into account the individual importance of plan attributes. Utilizing historic data, comparisons on prescription spending will be made to past patients who have a similar health-profile as identified by the current patient. The results of the tool will change for every user, based on their health profile. Along with the plan rankings, the tool also relays the monthly premium, deductible, number of prescription drugs covered, and estimated savings based on selected plan. Savings per patient averaged $1,243 per year, with a range from -$322.40 to $1,978.10. Tools such as the one described in this paper enable patients to make decisions with a full understanding of choices, associated risks, and sensitivities.