Trying to Limit eRx Functionality

When I first worked on electronic prescribing (eRx) back in 2001, there were grandiose expectations for the technology. A decade later, we’re finally starting to see adoption happen with over 20% of new Rxs (NRxs) written electronically according to several people. (see article or go to Surescripts for more data)

The holy grail of this technology is not simply to get a clean prescription sent electronically, but to minimize the more that 40% of NRxs which fall into the exception process for drug-drug interactions, step therapy rejects, or other follow-ups. (see prior post) That doesn’t even take into account the amount of times that cost is an issue for the patient leading to further work effort by the pharmacy and/or patient to get a new prescription. Obviously, cost is one of the issues which is driving the increased abandonment rate at the pharmacy.

Whether or not physicians should or will take on this additional responsibility at the point-of-care (POC) has always been a question…of course CMS incentives help. BUT, I was disappointed to hear from PCMA that some manufacturers are trying to limit the eRx functionality. They don’t want physicians to be able to:

• See lower cost alternatives
• See drug-drug interactions based on the patient’s history
• See lower cost pharmacy alternatives

That seems a little bitter to me. The manufacturers were one of the biggest advocates of the technology early on to the point where they saw lots of opportunities for promoting their brands. Fortunately, the vendors didn’t sell out as a vendor the retail pharmacies use for messaging did years ago. That vendor allowed the manufacturers to buy out a therapeutic class and didn’t allow any plan specific messaging to be delivered to the consumer which was very frustrating.