{"id":133442,"date":"2025-11-14T19:12:11","date_gmt":"2025-11-14T19:12:11","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/133442\/"},"modified":"2025-11-14T19:12:11","modified_gmt":"2025-11-14T19:12:11","slug":"the-700-copay-that-changed-everything","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/133442\/","title":{"rendered":"The $700 Copay That Changed Everything"},"content":{"rendered":"

<\/a>
\nToday\u2019s guest post comes from Stephen Hom, EVP, Chief Commercial Officer, and Co-Founder of RIS Rx.<\/p>\n

Stephen argues that patient affordability remains one of the most critical\u2014and often overlooked\u2014barriers to treatment adherence. Drawing on his experience as a community pharmacist, he suggests that cost isn\u2019t just a financial issue\u2014it\u2019s a clinical one.<\/p>\n

To learn about RIS Rx\u2019s Benefit Patient Solution (BPS) and other tools, request your savings snapshot<\/a>.<\/p>\n

Read on for Stephen\u2019s insights.

\n
The $700 Copay That Changed Everything
By Stephen Hom, EVP, Chief Commercial Officer, and Co-Founder, RIS Rx<\/p>\n

\"\"<\/a> More than 131 million patients<\/a> use prescriptions in the United States. Every year, many of them abandon their prescriptions, not because the medicine doesn\u2019t work, but because they can\u2019t afford it.<\/p>\n

I\u2019ve seen it myself.<\/p>\n

Back when I was managing a small community pharmacy, a patient I\u2019d been helping for months\u2014someone managing a tough, insulin-resistant case of Type II diabetes\u2014was standing at the counter, prescription in hand, panic in his eyes.<\/p>\n

The new insulin his doctor prescribed was working better than anything he\u2019d ever tried. But the copay? $700. In the rural community where I worked, that number might as well have been $7,000,000. He said quietly, \u201cIt\u2019s the only thing that works for me. I just can\u2019t afford it.\u201d <\/p>\n

Affordability Isn\u2019t Just a Financial Issue\u2014It\u2019s a Clinical One<\/p>\n

As a pharmacist, I\u2019d spent years learning everything about how drugs work. But in that moment with this patient, none of it mattered.<\/p>\n

The therapy was right, the prescription was approved, the coverage checked out. And still, the system had failed him. That\u2019s when it hit me: affordability isn\u2019t just a financial issue. It\u2019s a clinical one. If a patient can\u2019t afford to start therapy, the medicine never has a chance to help.<\/p>\n

We made calls, dug into every assistance program we could find, and brought his copay from $700 down to $0. When I told him, he laughed through tears and said, \u201cI\u2019d do backflips if I could.\u201d <\/p>\n

That moment has stayed with me ever since. It reminded me that for all our industry\u2019s complexity and sophistication, access is still deeply personal.<\/p>\n

The Costly Tug-of-War That Leaves Patients Behind<\/p>\n

According to GoodRx, about 1 in 3 Americans skips or delays filling prescriptions due to cost<\/a>. Medication cost is the top reason for unfilled prescriptions in the U.S.\u2014often because copay program complexity and shifting PBM rules leave patients confused or uncovered.<\/p>\n

One month, a patient might be enrolled in a program that brings their copay down to almost nothing. Two fills later, they\u2019re reclassified into a different one. And for every confused patient, there\u2019s a provider\u2019s office fielding calls and a manufacturer trying to make sense of why adherence dropped.<\/p>\n

At RIS Rx, we saw that chaos firsthand\u2014and we knew the answer couldn\u2019t be more retroactive audits.<\/p>\n

From 10-15 Patients Per Day to 10-15 Patients Per Second<\/p>\n

When I was working as a frontline pharmacist, I could help 10-15 patients a day with affordability. RIS Rx helps 10-15 a second.<\/p>\n

Our approach sets the stage from day one: monitoring in real time, evolving as programs and PBM rules evolve, and catching leakage before it happens.<\/p>\n

Why a proactive model wins: <\/p>\n

Accuracy in advance. We identify issues before they occur\u2014before they affect patients or performance.
Reduced noise. Fewer misclassifications mean fewer escalations, less provider frustration, and most importantly, a lower chance of patient dropping off of therapy.
Operational efficiency. Partners have been able to optimize staffing thanks to lower call volumes and cleaner processes.
Better outcomes. When patients stay informed and supported, adherence rises, and so does recovered value.
Accuracy matters: for the income statement, yes, but also for the experience.<\/p>\n

Fewer errors mean fewer phone calls, fewer complaints, and fewer physicians deciding to switch to a competitor just to stop the chaos.<\/p>\n

In fact, one of our manufacturer partners recently optimized their call-center staffing because the number of escalations dropped so dramatically after integrating RIS Rx. That\u2019s an operational, financial, and patient win. And the impact is real: In 2024, our customers saved $450 million. In 2025, we\u2019re forecasting over $1 billion in recovered revenue.<\/p>\n

How RIS Rx Keeps Access Connected\u2014and Recovers Over $1 Billion in Revenue <\/p>\n

Our team is pharmacist-led by design. Many of us, including myself and my co-founder Gerard Rivera, came from the front line. The expertise we built manually\u2014informed by thousands of real interactions and every nuance of benefit design\u2014is now embedded in our technology.<\/p>\n

Through our Benefit Patient Solution (BPS) and other tools, we identify disconnects in real time, make the right calls on behalf of patients and providers, and recover revenue that would otherwise be lost. The goal is a seamless experience: the patient, pharmacist, and provider don\u2019t see the complexity underneath. They just see that access works.<\/p>\n

When I look at our dashboards, I still picture patients like the man with the $700 copay. Every data header represents a part of that journey from prescription to affordability to adherence.<\/p>\n

See How We\u2019re Fixing Access: Get Your Savings Snapshot<\/p>\n

Every decision, every algorithm, every data point comes back to a simple goal: making sure no one has to choose between feeding their family and affording their medication.<\/p>\n

That\u2019s why we created the RIS Rx Savings Snapshot: a quick, shareable diagnostic that shows where your programs are leaking, how much you could be recovering, and what it means for the patients counting on you.<\/p>\n

See why we have a perfect NPS score: Click here to request your savings snapshot.<\/a> <\/p>\n

Sponsored guest posts are bylined articles that are screened by Drug Channels to ensure a topical relevance to our exclusive audience. The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish a guest post on Drug Channels, please contact Paula Fein<\/a> (paula@DrugChannels.net)<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"Today\u2019s guest post comes from Stephen Hom, EVP, Chief Commercial Officer, and Co-Founder of RIS Rx. Stephen argues…\n","protected":false},"author":2,"featured_media":133443,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[163,85,46,482],"class_list":{"0":"post-133442","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-health","9":"tag-il","10":"tag-israel","11":"tag-medication"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/133442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=133442"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/133442\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/133443"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=133442"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=133442"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=133442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}