PHARMACY

DEA ends restrictions on controlled substance e-Rx

BY Jim Frederick

With a regulatory stroke, the Obama White House has swept away the last serious legal hurdle set by the federal government to the nationwide conversion of the healthcare system to the electronic prescribing and transmission of prescription drugs.

The breakthrough came in June when the U.S. Drug Enforcement Administration struck down legal impediments to the electronic prescribing of controlled substances. The change comes with the agency’s release in June of interim final rules governing prescribing practices, which successfully culminated a 10-year battle by pharmacy and technology interests to modernize all facets of the prescription prescribing and dispensing process.

The federal prohibition against paperless prescribing of controlled substances—a prohibition based on outmoded concerns over the safety of digitally prescribed and stored prescriptions for higher-risk medications—had long bedeviled efforts by pharmacy and industry groups to spur universal adoption of the technology by the nation’s prescribing physicians. The DEA’s decision to eliminate that barrier marked a major victory for those groups.

Chain pharmacy representatives were jubilant. “This is the first time ever that there can be a coordinated e-prescribing system for both controlled and noncontrolled prescription medication,” the National Association of Chain Drug Stores stated. “The prior inability to utilize e-prescribing for controlled substances frequently was reported as a major barrier to physician adoption of e-prescribing.”

NACDS president and CEO Steve Anderson said the DEA’s decision marked “truly a historic day for the healthcare system, as this rule will allow much-needed health information technology solutions to better serve patients.”

NACDS and other groups have worked collaboratively over the past decade with the DEA, the Department of Health and Human Services, pharmacy partners, such intermediaries as Surescripts, technology vendors and others to extend paperless prescribing to controlled substances. In partnership with the National Community Pharmacists Association, the chain pharmacy group created Surescripts in 2001 to foster the nationwide adoption of e-prescribing and provide a network platform for its use.

More than 97% of the nation’s chain community pharmacies now use pharmacy applications that have been tested and certified through Surescripts, according to NACDS, and the number of prescriptions routed electronically grew from 68 million in 2008 to 191 million in 2009.

Despite those gains, however, a large majority of family physicians and their practices—roughly 3-out-of-4 of them—still hand-write prescriptions and rely on their patients to carry them to the pharmacy for dispensing.

Although “electronic health record adoption is picking up rapidly, with an estimated 27% of physicians using some kind of EHR, the vast majority of medical records in the United States are still on paper, with the average appointment taking 13 pages to document,” confirmed Karen Riley, a spokeswoman for the New York eHealth Collaborative and the NYC Regional Electronic Adoption Center for Health.

The adherence problem—whereby many patients simply never even fill a written prescription—also points to the gap that remains between the point of prescribing and the local pharmacy. That gap swallows many written scripts. In one recent study, researchers at Harvard Medical School found the problem of “primary nonadherence” is rampant. Tracking 75,000 patient visits, they found that 22% of first-time patient prescriptions were never filled.

Allowing e-prescribing of tightly controlled pain relievers and other medications likely won’t bridge most of that gap. But it will help simplify the prescribing process for family doctors and specialists.

Opening controlled substances to the world of electronic data storage and communications has long been a top priority for Surescripts. “There’s a high demand for it, both at the state level, where they want to track the use of controlled substances, as well as at the federal level,” former Surescripts CEO Kevin Hutchinson told Drug Store News.

Now, that hurdle has been vaulted. The real transformation of the nation’s healthcare system still depends on how quickly doctors embrace health information technology.

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PHARMACY

Novartis reports positive Q2

BY Alaric DeArment

BASEL, Switzerland Sales and profits grew significantly for Swiss drug maker Novartis, with significant growth across divisions, according to the company’s second-quarter earnings report.

Novartis reported an 11% increase in net sales, to $11.7 billion, compared with $10.5 billion in second quarter 2009, while profits grew by 19%, to $2.4 billion, compared with $2 billion the year before.

The company’s major products mostly saw increases in sales; the cancer drug Gleevec (imatinib mesylate) had sales of $1 billion, compared with $990 million in second quarter 2009, while sales of the once-yearly osteoporosis treatment Reclast (zoledronic acid) increased from $115 million to $142 million.

Sandoz, the drug maker’s generics division, had an 11% sales increase, to $1.9 billion, compared with $1.7 billion in second quarter 2009.

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Domann joining Kerr Health: Another sign of sweeping changes

BY Jim Frederick

WHAT IT MEANS AND WHY IT’S IMPORTANT Rounding out its Kerr Health management team, Kerr Drug has gone beyond its own deep bench of retail-oriented players.

(THE NEWS: Domann named Kerr Health’s VP sales and business. For the full story, click here)

For the past year, the company, which dominates drug store retailing in its home state of North Carolina, has been fine-tuning a new pharmacy-care business model aimed at employers and built on its solid foundation as a pharmacy and healthcare innovator. So it’s no surprise that Kerr turned to a highly experienced pharmaceutical industry veteran to head up sales and new-business efforts for the fast-growing health-services operation.

That choice is Dick Domann, an affable, 30-year drug industry veteran who forged a successful, 27-year drug-channel sales career with GlaxoSmithKline. As such, he’s forged close ties with retail pharmacy and is intimately familiar with its concerns, capabilities and potential as a patient-centered solution to America’s healthcare woes. As Kerr Health’s first VP sales and business, Domann brings a broad perspective in pharmaceutical marketing, managed care and government relations to Kerr, which is working to burnish its credibility with employer-based health plans in North Carolina and elsewhere.

Domann also is no stranger to Kerr’s operating region. Since 1987, he’s called North Carolina home –– GSK is based in the state’s famed Research Triangle district near Duke University, the University of North Carolina and other centers of learning and medical practice –– and he’s been active in local community, business and political organizations for many years. He’s also a fledgling novelist, having authored and published one novel, with another on the way.

Domann’s induction is another sign of the sweeping changes ongoing at Kerr, which has firmly established its bona fides as one of retail pharmacy’s best healthcare innovators. Kerr Health, the health-services division of Kerr Drug, encompasses a wide gamut of pharmacy-based patient services – including disease management, medication therapy management, employer-based inoculation and clinical-care services, long-term care and specialty pharmacy.

Much like Walgreens, Kerr is focused on expanding the range of clinical and pharmacy services it can provide to employer-sponsored health plans and managed care organizations. It bills its vision for patient health as “holistic” in terms of its view of the patient, and positions its services as an adjunct to the care provided by time-stressed physicians and community health centers.

“Kerr Health synergistically unites Kerr Health Care Services and KDI Health Solutions, two subsidiaries of Kerr Drug, Inc., one of the nation’s leading and most respected names in the chain drug industry,” the company notes in a description of its offerings. “Kerr Health provides a broad and customizable offering of value-driven products and services to medical practices, patients, employer groups, long-term care facilities, and municipalities.”

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