PCPs face multiple challenges with e-prescribing systems
By Mia Burns (email@example.com)
Although primary care physicians are e-prescribing more than before to increase accuracy and decrease costs, a new report from SciMedica Group Marketing Research & Consulting has revealed that these physicians are encountering significant obstacles with current e-prescribing systems, particularly in accessing accurate formulary information and prescribing branded products. The limitations tend to favor generic prescribing, which not only threatens the sales of established branded products, but also the growth of new brands. These factors provide the pharma industry with a powerful incentive to help improve e-prescribing systems.
However, more than a third of surveyed physicians indicated that they believe that the pharma industry should not become involved in e-prescribing improvements, according to SciMedica executives. In contrast, nearly half said that pharma should partner with e-prescribing software providers to ensure the accuracy of information within their systems, and 34.5 percent said that pharma should provide grants or loans to install e-prescribing systems.
“Within our study data and anecdotally, we have not heard much regarding pharma partnerships with software providers in terms of improving data accuracy, but it still may be too early for that to occur,” says Eric John, senior VP, SciMedica Group Marketing Research and Consulting. “From a big picture perspective, there must be a comprehensive, coordinated effort on the part of pharma that includes an effective contracting and rebating strategy in conjunction with improving the quality of information within e-prescribing systems. Helping to ensure the accuracy of formulary-related information in an e-prescribing system is only one step in the process. To close the loop, pharma must also make sure their products stand out in the e-prescribing system with better access from health insurance plans such as optimized formulary tier and minimal prior authorization requirements.”
In addition, John told Med Ad News Daily that SciMedica has yet to hear about pharma providing grants or loans to install e-prescribing systems. “In discussions with a few clients, they identified several potential legal issues or challenges to providing financial support to a practice in this age of the Sunshine Act,” he says. “In the short term, e-prescribing preparedness on the part of the sales force may be the most effective support pharma can provide to e-prescribing physicians and practices.”
The most striking finding of the SciMedica Group MR&C EPS report is that formulary information, including prior authorization, co-pays and other “utilization management” requirements, is frequently unavailable in current systems, according to participating physician respondents. Less than half said that they have access to formulary information when e-prescribing and less than a third indicated that they have access to prior authorization or co-pay information. Additional factors cited as limiting e-prescribing include the inability to e-prescribe controlled substances, technical difficulties transmitting e-prescriptions to pharmacies, and problems caused by missing or inaccurate patient information.
“There are several factors that contribute to the current limited availability of formulary information in physicians’ e-prescribing systems,” John told Med Ad News Daily. “First, some physicians labeled inaccurate formulary information in their system as ‘unavailable information.’ If an e-prescribing system is not updated on a regular basis, physicians are unsure whether the formulary information in that system is correct or not, so they don’t use that feature. In these cases, they fall back on their old sources regarding formulary status, but are not getting the full benefit of the e-prescribing system in which they invested. Second, inadequate system training and partial physician experience with e-prescribing systems definitely contribute to the perception of limited formulary information access. Physicians were generally favorable in terms of the training they received for their e-prescribing systems, but only 30.5 percent indicated any personalized training on their particular system. A third reason for the lack of formulary access in e-prescribing software is the relationship between price levels for these systems and the corresponding features or options available at each price level. Through their responses, physicians indicated that they are very sensitive to the cost of e-prescribing systems, yet they also have been eager to start e-prescribing in order to earn Medicare Part B incentives or avoid the penalties. So in order to e-prescribe at required levels while minimizing costs to their practices, many physicians appear to have opted for lower price systems with potentially fewer features or options.”
According to John, roughly 43 percent of physicians said that the cost of their system was less than $10,000, with 20 percent saying it was “free.” Despite this, SciMedica found that the higher price e-prescribing systems were also more likely to have complete formulary information, clearer menu navigation, and more comprehensive patient information available. “For example, all respondents using one particular company’s e-prescribing system reported paying at least $5,000 for it,” he told Med Ad News Daily. “Coincidentally, that company also ranked the highest across several e-prescribing software features assessed in our research. In essence, part of the limited formulary access problem is that ‘you get what you pay for.’”
Physicians in the study struggled with identifying short term solutions regarding making formulary information more readily available, John says. “Physician responses seemed to indicate a desired arm’s-length relationship with pharma in terms of e-prescribing,” he told Med Ad News Daily. “The longer term trend indicates e-prescribing systems will continue to evolve, so that even the base option in these systems will be more up-to-date with formulary information. In the meantime, it may be in the pharma industry’s best interest to help physicians identify which systems are most comprehensive in terms of critical features like formulary information access. Helping physicians make better informed decisions regarding these potentially significant investments in their practices will help pharma enhance its relationship with the physician community. For example, if an entire pharma sales force is thoroughly prepared to address a physician’s questions regarding the status of the company’s products within all the various e-prescribing systems, there is an opportunity to build a relationship with the customer, especially if that information results in favorable access status for the product.”
On the subject of missing or inaccurate patient information, John says, “If the particular system has the capability to record detailed patient information, then it is in the patient’s best interest to spend some time with the practice staff to make sure his or her medical history is up-to-date within the system. This is especially true when a patient is forced to switch physicians or practices because of a change in insurance coverage. Physicians in our survey expressed general frustration with getting callbacks from a patient or pharmacy regarding a potential drug-drug interaction or bad past medicine experience because the e-prescribing system either did not have access to or did not contain up-to-date patient information.”
Posted: October 2013