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Prescription Management

E-prescribing shown to improve outcomes, save billions

Study quantifi es relationship between e-prescribing and medication adherence, with potential savings of $140 billion over the next 10 years.


urescripts recently announced study fi ndings from de-identifi ed data that link e-prescribing to a signifi - cant increase in fi rst-fi ll medication adherence. Poor adherence to medication therapy is a large and costly

problem in the U.S. The World Health Organization estimates that as many as 50 percent of patients do not adhere fully to their medication treatment[1], leading to 125,000 premature deaths and billions in preventable healthcare costs[2]. The Surescripts analysis suggests that the increase in fi rst-fi ll medication adherence combined with other e-prescribing benefi ts could, over the next 10 years, lead to between $140 billion and $240 billion in healthcare savings and improved health outcomes. Earlier this year, Surescripts collaborated with pharmacies and pharmacy benefi t managers on a study to quantify the benefi ts of e-prescribing. Reviewers analyzed de-identifi ed data sets representing over 40 million prescription records – comparing electronic prescriptions with paper, phoned and faxed prescriptions – to measure the impact on fi rst-fi ll medication adherence.*

The data showed a consistent 10 percent increase in pa-

tient fi rst-fi ll medication adherence (i.e., new prescriptions that were picked up by the patient) among physicians who adopted e-prescribing technology when compared with physi- cians who did not use e-prescribing. Physicians who adopted e-prescribing used the technology to route up to 40 percent of their prescriptions electronically during the time of the study, and Surescripts estimates that fi rst-fi ll medication adherence rates will continue to improve as e-prescribing adoption and usage increase.

“The Surescripts analysis is an important contribution to a growing body of literature on e-prescribing and on medica- tion adherence,” says William H. Shrank, M.D., MSHS, of Harvard Medical School and medication adherence expert and researcher. “In a huge study, they have shown a clear link between e-prescribing and fi rst-fi ll medication adherence. This speaks to the potential of technology to improve the effi cacy of drug therapy, which ideally should promote better health outcomes and reduce costs.”

22 April 2012

Study examines e-prescribing and medication adherence

E-prescribing impact on fi rst-fi ll adherence rates out of 100 written prescriptions

De-identifi ed data from 2008 – 2010; multiple data sources E-prescribing physician

Prescriptions written per month** Prescriptions that make it to the pharmacy

Prescriptions picked up by patients

Pre-adoption Post-adoption Dif ference 0.0%

100.0 73.2


100.0 81.8

+11.7% 76.5 +10.0%

*Data presented in this table offer a simplifi ed view of prescription adherence rates for a typical e-prescribing physician 12 months prior to and 12 months post-adoption of e-prescribing technology. E-prescribing utilization rates among e-prescribing physicians during the post- adoption ranged from 30% – 40%; at 100% utilization rate, Surescripts expects 100% of prescriptions to make it to the pharmacy. Actual study was conducted with multiple retail chain pharmacies and pharmacy benefi t managers, and compared longitudinal and post vs. pre results against a control group of non-e-prescribing physicians; the data presented in this table accurately refl ect the study fi ndings and have been simplifi ed for communication purposes.

**Prescriptions written per month refl ect Surescripts’ estimates based on calculations from study data and previous studies.

The Surescripts study suggests two key factors contribute to the increase in fi rst-fi ll adherence. First, prior studies have found as high as 28 percent of paper prescriptions never make it to the pharmacy[3], a well-known but diffi cult-to-address problem known as “prescription leakage.” In contrast, when a physician elects to send a prescription electronically to the patient’s choice of pharmacy, the prescription is immediately sent to the pharmacy. Second, the study validates previous fi ndings that patient copay is highly associated with prescrip- tion abandonment rates[4], or the percent of prescriptions not picked up at the pharmacy. Surescripts’ analysis con- fi rms that the higher the copay, the more likely it is that the prescription will be abandoned by the patient. The “sticker shock” that occurs when a patient arrives at the pharmacy to pick up their prescription has been a chronic problem facing pharmacies and physicians, but it can be addressed through the e-prescribing process.

“E-prescribing provides physicians with the patient’s in- surance and medication history information during a patient visit, which can lead to a more clinically appropriate prescrip- tion with a lower out-of-pocket cost for the patient,” says Ken Majkowski, PharmD, and vice president of strategy and innovation at Surescripts. “When the doctor e-prescribes,


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