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2/1/2012
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E-Prescribing Could Save $240 Billion, Study Says

Surescripts research tracks higher Rx fill rates, better patient medication adherence with electronic prescriptions.

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Electronic prescribing could help reduce healthcare expenditures by $140 billion to $240 billion over the next 10 years by improving patient adherence to medication regimens, according to a new study.

E-prescribing network Surescripts joined with pharmacies and pharmacy benefit managers to examine more than 40 million de-identified records of paper, phoned-in, faxed-in, and electronic prescriptions, and found the rate of first prescriptions actually being filled and picked up to be 10% higher when prescriptions were written electronically. Higher first-fill rates generally lead to better medication adherence, fewer doctor visits, and reduced risk of hospitalization.

"Improved medication adherence results in lower downstream medical costs," lead researcher Seth Joseph told InformationWeek Healthcare. Joseph also said that e-prescribing "positively impacts generic utilization," and generic drugs do cost less than brand-name products. Generics also tend to have higher profit margins for pharmacies.

[ For more background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch. ]

"It's a good story for patients. It's a good story for pharmacies as well," Joseph said.

According to the Surescripts study, for every 100 paper prescriptions, 73.2 are delivered to a pharmacy and 69.5 are actually picked up. But with a 60/40 ratio of paper-to-electronic prescriptions--in other words, 60% of doctors write paper scripts vs. 40% writing e-scripts--the delivery rate rises to 81.8%, while 76.5% get picked up.

Predictably, the Surescripts study confirmed previous work that found higher rates of prescription "abandonment," which pharmacies refer to as a return to stock. "We suspect that [pharmacies] are getting more prescriptions," Joseph said. Patients don't always take paper prescriptions to get filled, while e-prescriptions are more likely to make it to the pharmacy and get filled, even if patients don't pick their medications up, he explained.

According to Joseph, 22% to 28% of paper prescriptions never even get to the pharmacy, based on previous research, including a 2010 study in the Journal of General Internal Medicine led by pharmacoeconomics expert Dr. Michael A. Fischer of Partners HealthCare in Boston. "When we look at our data in different ways, it really corroborates Fischer's work," Joseph said.

"The Surescripts analysis is an important contribution to a growing body of literature on e-prescribing and on medication adherence," Harvard Medical School medication-adherence researcher Dr. William H. Shrank said in a Surescripts statement.

"In a huge study, they have shown a clear link between e-prescribing and first-fill medication adherence. This speaks to the potential of technology to improve the efficacy of drug therapy, which ideally should promote better health outcomes and reduce costs," added Shrank, who also participated in the Fischer-led study.

When are emerging technologies ready for clinical use? In the new issue of InformationWeek Healthcare, find out how three promising innovations--personalized medicine, clinical analytics, and natural language processing--show the trade-offs. Download the issue now. (Free registration required.)

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