Government

Pharmacy benefit managers push Medicare e-prescribing

The AMA sees the move as an unfunded mandate for physicians.

By David Glendinning — Posted Aug. 13, 2007

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The trade group representing pharmacy benefit managers has launched a campaign urging Congress to require physicians to use electronic prescribing in Medicare.

Switching from paper-based drug orders to e-prescribing would be the right move from both a financial and safety standpoint, says the Pharmaceutical Care Management Assn. In a PCMA-commissioned study, the Gorman Health Group concluded that requiring doctors and pharmacies to handle all Part D prescriptions electronically by 2010 would reduce federal health care costs by $29 billion and avoid 1.6 million adverse drug events over the next decade.

A PCMA survey of more than 400 doctors found that most physicians agree that e-prescribing would save money and reduce medication errors. But nearly two out of three respondents said they did not consider adopting electronic prescribing technology a priority.

The association supplemented its study and survey with print ads timed to coincide with this year's congressional debate on Medicare physician payment. "As Congress weighs a $30 billion payment update for Medicare physicians, it should also consider requiring Medicare doctors to use e-prescribing," the ads state.

But now would be the wrong time to make such a policy shift, said American Medical Association Chair-elect Joseph M. Heyman, MD.

"Physicians are eager to adopt new technologies that have the potential to increase patient safety and quality of care, but hitting doctors with an unfunded e-prescribing mandate at the same time the government plans to cut Medicare physician payments 10% next year is untenable," he said.

The PCMA proposes a 1% Medicare payment incentive for doctors to help defray e-prescribing technology costs. At $26 billion over a decade, net federal savings still would be significant, said PCMA President Mark Merritt. That's near the amount needed to fund a temporary physician payment solution, he said. Most physicians surveyed who said e-prescribing was not a priority cited cost or administrative barriers as the main reason.

Merritt said pharmacy benefit managers would benefit from increased use of e-prescribing because the resulting efficiency gains would help them save money for the private payers that contract with them. But the National Community Pharmacists Assn. believes that the managers are trying to drive the issue because they could use e-prescribing to push more Medicare Part D enrollees into using the benefit manager's mail-order pharmacies, said Charlie Sewell, an NCPA senior lobbyist.

NCPA supports a move toward e-prescribing because it would give doctors and pharmacists closer access to data about drugs and their potential interactions with each other. But the group would need to evaluate any legislation that comes up to determine whether it would be too burdensome, Sewell said.

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ADDITIONAL INFORMATION

Not in practice

A recent survey of more than 400 physicians conducted for the Pharmaceutical Care Management Assn. by Ayres, McHenry & Associates Inc. found that most doctors thought electronic prescribing was good for medicine.

Good idea 85%
Bad idea 9%
Don't know/no opinion 6%
100%

But few physicians reported that they used e-prescribing technology to handle patients' drug orders.

Write order 79%
E-prescribe 7%
Call pharmacy 5%
Combination 8%
Other 1%
100%

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