Study: E-Prescribing Shown to Improve Outcomes and Save Healthcare System Billions of Dollars
Wednesday, February 1, 2012
FOR IMMEDIATE RELEASE
STUDY: E-PRESCRIBING SHOWN TO IMPROVE OUTCOMES AND SAVE U.S. HEALTHCARE SYSTEM BILLIONS OF DOLLARS
Study Quantifies Relationship between E-Prescribing and Medication Adherence, With Potential Savings of $140 Billion over the Next 10 Years
ARLINGTON,
Va. - Feb. 1,
2012 - Surescripts, the nation's
e-prescription network, today announced study findings from
de-identified data that link e-prescribing to a significant
increase in first-fill 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 health care
costs[2]. The Surescripts analysis suggests
that the increase in first-fill medication adherence combined with
other e-prescribing benefits could, over the next 10 years, lead to
between $140 billion and $240 billion in health care savings and
improved health outcomes.
Earlier this year, Surescripts collaborated with pharmacies and
pharmacy benefit managers on a study to quantify the benefits of
e-prescribing. Reviewers analyzed de-identified data sets
representing over 40 million prescription records - comparing
electronic prescriptions with paper, phoned- and
faxed-prescriptions - to measure the impact on first-fill
medication adherence.*
The data showed a consistent 10 percent increase in patient
first-fill medication adherence (i.e., new prescriptions that were
picked up by the patient) among physicians who adopted
e-prescribing technology when compared with physicians 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 first-fill 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 medication adherence," said William H. Shrank, MD, 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 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."
Study Examines E-Prescribing and Medication Adherence
|
E-Prescribing Impact on First Fill Adherence
Rates* |
|||
| E-Prescribing Physician | |||
| Pre-adoption | Post Adoption | Difference | |
| Prescriptions written per month** | 100.0 | 100.00 | 0.0% |
| Prescriptions that make it to the pharmacy | 73.2 | 81.8 | +11.7% |
| Prescriptions picked up by patients | 69.5 | 76.5 | +10.0% |
| *Data presented in this table offer
a simplified 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 benefit 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 reflect the study findings and have been simplified for
communication purposes. **Prescriptions written per month reflect Surescripts' estimates based on calculations from study data and previous studies. |
|||
The Surescripts study suggests two key factors contribute to the
increase in first-fill adherence. First, prior studies have found
as high as 28 percent of paper prescriptions never make it to the
pharmacy , a well known but difficult-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 findings that patient copay is
highly associated with prescription abandonment rates , or the
percent of prescriptions not picked up at the pharmacy.
Surescripts' analysis confirms 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 can be addressed
through the e-prescribing process.
"E-prescribing provides physicians with the patient's insurance
and medication history information during a patient visit, which
can lead to a more clinically appropriate prescriptions with a
lower out-of-pocket cost for the patient," said Ken Majkowski,
PharmD and vice president of strategy and innovation at
Surescripts. "When the doctor e-prescribes, the patient is more
likely to know that the prescription has a lower out of pocket
cost. When you combine this with the fact that it will be
electronically routed to the pharmacy - which makes it more
convenient for the patient and provides more information to the
pharmacist - you have a great opportunity to improve medication
adherence."
Study Furthers Understanding of Prescription Abandonment Rates
Previous studies have found that e-prescriptions have higher
abandonment rates than non
e-prescriptions[5]. The Surescripts study
confirms this and adds context by demonstrating that
e-prescriptions have higher abandonment rates in part because more
prescriptions make it to the pharmacy.
"Paper prescriptions appeared - at first glance - to have a lower abandonment rate," said Majkowski. "But historically, the pharmacy could only measure those paper prescriptions that were brought into the pharmacy by the patient. When you consider all of the paper prescriptions that don't make it to the pharmacy, the true prescription abandonment rate for paper prescriptions is dramatically higher. Our study suggests that, compared to the true abandonment rate of paper prescriptions, e-prescriptions are actually abandoned at a far lower rate."
Findings Suggest E-Prescribing Will Help Improve Outcomes
and Lower Health Care Costs
Today, 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[6]. This non-adherence
contributes to 125,000 premature deaths annually as well as to
other patient safety concerns that cost the healthcare system an
estimated $290 billion annually in the form of increased
hospitalizations and costly
complications[7].
A 2011 study found that every dollar spent on improving patient
adherence to medication can result in three to ten dollars of
savings from reduced downstream medical costs for certain
diseases[8]. Given health care policy makers'
and industry leaders' objectives to reduce costs and improve the
quality of care, improving medication adherence can be a key lever
in achieving those goals.
The Surescripts study suggests that e-prescribing is already
significantly contributing toward meeting the cost and quality of
care objectives by improving first-fill medication adherence.
"There are many contributing factors to medication non-adherence - social, economic, degree of health literacy, support system, and still others that we are still learning about," said Majkowski. "E-prescribing is not a panacea and does not solve for all of these. However, it is evident from the data that e-prescribing is already positively impacting first fill medication adherence rates and should be considered a powerful tool in the healthcare system's efforts to address medication adherence and improve patient outcomes."
Click view a downloadable graphic detailing the study
results.
# # #
* No patient identifiable data was used in the analysis. The study
was conducted on a retrospective, longitudinal, pre-post basis
comparing outcome metrics for electronic prescribing physicians
(Test Group) vs. non-electronic prescribing physicians (Control
Group). The study involved more than 50,000 active prescribers
(representing Test and Control physicians) across 50 states using
over 200 e-prescribing applications, four different pharmacy and
PBM organizations, and de-identified data sets representing over 40
million prescription records. Data was analyzed over a three year
period, from 2008 to 2010. To account for seasonal and
macroeconomic influences on prescribing patterns, baseline data was
collected for all Test (electronic prescribing) and Control
(non-electronic prescribing) physicians prior to the time of
adoption, and compared to results following adoption; the pre- and
post- periods were determined by the time of e-prescribing adoption
by the Test group physicians and a pseudo-adoption date randomly
generated for each Control group physician. Criteria for inclusion
in the Test Group included adoption of e-prescribing technology
during the 2009 calendar year.
About Surescripts
The Surescripts network supports the most comprehensive ecosystem of healthcare organizations nationwide. Pharmacies, payers, pharmacy benefit managers, physicians, hospitals, health information exchanges and health technology firms rely on Surescripts to more easily and securely share health information. Guided by the principles of neutrality, transparency, physician and patient choice, open standards, collaboration and privacy, Surescripts operates the nation's largest health information network. By providing information for routine, recurring and emergency care, Surescripts is committed to saving lives, improving efficiency and reducing the cost of health care for all. For more information, go to www.surescripts.com and follow us at twitter.com/surescripts.
Press Contact:
Rob Cronin
Surescripts
917-414-5289
rob.cronin@surescripts.com
[1] World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: WHO, 2003
[2] Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Mediation Adherence for Chronic Disease. NEHI (August 2009).
[3] Fischer, M.A., Stedman, M.R., Lii, J., Vogeli, C., Shrank, W.H., Brookhart, M.A., & Weissman, J.S. (2010). Primary medication non-adherence: Analysis of 195, 930 electronic prescriptions. Journal of General Internal Medicine, 25 (4), 284-290.
[4] Shrank, W.H., Choudry, N.K., Fischer, M.A., Avorn, J., Powel, M., Schneeweiss, S., Liberman, J., Dollear, T., Brennan, T.A., Brookhart, M.A. (2010). The Epidemiology of Prescriptions Abandoned at the Pharmacy. Annals of Internal Medicine, Vol. 153, No. 10, 633 - 640
[5] Shrank, ibid.
[6] World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: WHO, 2003
[7] Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Mediation Adherence for Chronic Disease. NEHI (August 2009).
[8] M. Christopher Roebuck, Joshua N. Liberman, Marin Gemmill-Toyama and Tryoen A. Brennan. Medication Adherence Leads To Lower Health Care Use And Costs Despite Increased Drug Spending. Health Affairs, 30, no. 1 (2011):91-99.
