New players in electronic prescribing

Insurers and pharmacy benefit managers are investing in or developing systems to reduce costs and increase compliance with drug formularies.

By Tyler Chin, AMNews staff. Feb. 25, 2002.

As several managed care companies and pharmacy benefit managers are getting involved in the electronic prescribing system business, some doctors are wary about what they see as a means for plans to muscle their way further into the prescribing process.

Some companies, including Aetna Inc. and Tufts Health Plan, are in the early stages of testing electronic prescribing technology or collaborating with makers of handheld prescribing systems to offer doctors access to their drug formulary at the point of care.

Others have acquired electronic prescribing technology from companies that hit a financial wall partly because doctors wouldn't use and pay for their services. Last year, for example, Rx-Connect, a division of PacifiCare Health Systems, Santa Ana, Calif., bought the technology assets of Parkstone Medical Information Systems at a federal bankruptcy court auction for $1.15 million in stock and cash.

Some physicians wonder whether these moves could give insurers and PBMs too-easy access to their prescribing patterns. Insurers and PBMs are being pressured by corporate payers and others to put a lid on the 17% to 20% annual increases in drug costs.

"The only thing that stops them from doing that a lot more is the amount of work that it would take them to retroactively question every prescription," said Andre S. Chen, MD, a family physician at a 130-doctor group in Austin, Texas. "If they can do it in a much more efficient [and less expensive] manner, then I think they will."

Although he frequently uses a handheld for coding and references, Dr. Chen does not use it for prescribing because he says it would make the process more complex. By handwriting prescriptions, he doesn't have to worry about the handheld or personal digital assistant being hooked up to the server, the server hooked up to the network, the pharmacy being hooked up to the network or whether the pharmacy's fax is working. [...]