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Citing Medicare savings, group says doctors should have to e-prescribe |
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By Jeffrey Young
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Posted: 07/12/07 07:02 PM [ET] |
The Pharmaceutical Care Management Association (PCMA) today is launching a campaign to promote electronic prescriptions by asking Congress to mandate that physicians adopt the technology if they want to treat Medicare patients.
Though the gambit has provoked objections from the physician lobby, the PCMA is hoping that the promise of billions in savings to the federal government will appeal to lawmakers eager to find offsets for new healthcare spending.
One of the biggest new healthcare expenditures facing Congress this year is a temporary fix to the Medicare payment formula for physicians themselves. Without action, Medicare will cut payments to doctors by 10 percent next year — but stopping that cut could cost taxpayers tens of billions of dollars.
According to a PCMA-commissioned study by the Gorman Health Group, the organization’s preferred policy would save $26.3 billion over 10 years.
“Hitting doctors with an unfunded e-prescribing mandate at the same time the government plans to cut Medicare physician payments 10 percent next year is untenable,” American Medical Association (AMA) board member Joseph Heyman said in a written statement. The Congressional Budget Office “has not identified any savings to the Medicare program from e-prescribing,” Heyman added.
The PCMA is trying to spur wider and more rapid adoption of the technology through Medicare because the program is so large it can practically dictate national standards.
Wider adoption of electronic prescribing, or e-prescribing, also would provide the PCMA’s members with a much larger market for the mail-order pharmacy services they provide. The PCMA represents pharmacy benefit management companies, which administer prescription drug benefits for private insurers and Medicare Part D.
The concept of e-prescribing is widely endorsed throughout the healthcare sector, including by physician groups such as the AMA, the pharmacy lobby, represented by the National Association of Chain Drugstores (NACDS) and the National Community Pharmacists Association (NCPA), and the pharmacists themselves through the American Pharmacists Association.
The NACDS and the NCPA have been creating their own e-prescribing infrastructure at the retail level since 2001 through a company they co-own called SureScripts.
The federally chartered Institute of Medicine has called for a complete switch to e-prescribing by 2010, but implementation of e-prescribing in the marketplace has been slow.
Physician groups have said the upfront costs of obtaining the technology are prohibitive, a concern echoed by the NCPA, which represents many small pharmacies. The PCMA also commissioned a survey of physicians, conducted by Ayres, McHenry & Associates, that found just 7 percent of doctors already employ the technology.
The PCMA proposal also includes a recommendation that Medicare offer payment bonuses to physicians, valued at $7 billion over 10 years, to help them purchase and maintain the computer hardware and software they would need to file their prescriptions electronically.
In addition to the potential for budgetary savings, the PCMA is trumpeting the clinical and practical benefits of e-prescribing for doctors and patients.
For example, PCMA says physicians and patients would have complete access to information about the drugs available under the patients’ private or government insurance plans and e-prescribing would reduce harmful and costly medical errors resulting from mistakes filing and filling prescriptions. According to the Gorman Health Group analysis, using e-prescribing in Medicare Part D would prevent 1.9 million so-called adverse drug events over 10 years.
Congress has attempted to mandate e-prescribing before. The House passed such language in its version of the 2003 law that created Medicare Part D but it did not survive conference. In the meantime, the Department of Health and Human Services has been developing e-prescribing standards and conducting pilot programs under Medicare. No lawmaker has introduced legislation this year to mandate e-prescribing under Medicare.
The PCMA is staging a press conference on its plan this afternoon and has purchased advertising space in Washington publications, including The Hill. The group also sent a letter to Capitol Hill outlining its agenda on e-prescribing.
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