Merritt: Policymakers Recognize the Importance of EMRs Including E-Prescribing  

(Washington, DC)- As both the U.S. Senate and House work to complete health-information technology (HIT) provisions within the economic recovery package, the Pharmaceutical Care Management Association (PCMA) today sent a letter to the U.S. House of Representatives outlining concerns with several medical privacy provisions in the current House legislation.

PCMA represents the nation’s pharmacy benefit managers (PBMs), which have demonstrated a proven ability to generate tremendous efficiencies managing prescription drug benefits through the use of electronic prescribing (e-prescribing) and other technologies for the 200-plus million Americans with coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

“We are encouraged that policymakers recognize the importance in funding EMRs which use e-prescribing,” said PCMA President and CEO Mark Merritt.   “However, spending billions on new HIT systems that contain unworkable privacy provisions would waste an historic opportunity to improve chronic care and prevent countless medical errors and hospitalizations.”

PCMA Letter to the US House of Representatives

EMRs Must Include E-Prescribing:

Avoid Wasteful Spending, Meet President-Elect’s Five-Year Timeline

Resist Privacy Provisions Which Impede Adoption and Reduce Patient Access to Life-Savings Technologies

(Washington, DC)- As policymakers consider health information technology (HIT) provisions within the economic recovery package, the Pharmaceutical Care Management Association (PCMA) today offered several guidelines designed to ensure that new HIT investments accomplish the desired goal of avoiding wasteful spending.

PCMA represents the nation’s pharmacy benefit managers (PBMs), which have demonstrated a proven ability to generate tremendous efficiencies managing prescription drug benefits through the use electronic prescribing (e-prescribing) and other technologies for the 200-plus million Americans with coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

“HIT legislation presents an opportunity for huge success if policymakers ensure that all electronic medical records include basic safety tools like e-prescribing, which improves efficiency, affordability, and access,” said PCMA President and CEO Mark Merritt.  “However, spending billions on new HIT systems that don’t include e-prescribing, are not interoperable with other EMR technologies, or contain unworkable privacy provisions would be more than just a waste of money.  It would waste an historic opportunity to improve chronic care and prevent countless medical errors and hospitalizations.”

Specifically PCMA recommends the following five HIT guidelines:

• Increase accountability by rewarding the use – not simply the purchase – of EMR technologies.  Build on the accountability provisions in Medicare’s new e-prescribing incentives program which specifies that funds only go to providers who actively use the technology.

• Fund only those EMRs which use “real” e-prescribing, as defined in Medicare. In the Congressional Budget Office’s (CBO) definition of HIT, all “qualified” EMRs must have e-prescribing capability, yet less than 50 percent of currently used systems do.  Many simply print out or file prescriptions, but do not enable providers to prevent dangerous “drug-drug” interactions.  Building upon the success of last year’s Medicare bill (that is expected to increase provider adoption of e-prescribing to 40 percent within the next five years), new HIT funding could nearly double that adoption rate within the same period if done correctly.

• All qualified HIT must be certified by a third party as meeting national interoperability standards.  Providers and the government need assurances that all HIT systems are able to communicate with each other.

• Support President-Elect Obama’s five year plan for HIT.  President-elect Obama’s goal is for all of America’s medical records to be computerized within five years.  To ensure accountability and avoid waste, there must be a clear commitment to achieve this important goal.

• Privacy is important…but so is patient safety.  Privacy should be considered in the broader HIT context of encouraging adoption of technologies that improve health care safety and efficiency.  It would be an unfortunate irony if any new privacy provisions (i.e. beyond HIPAA) resulted in higher costs, increased inefficiency, lower provider adoption, and less patient access to life-saving technologies.

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New Government Research Finds Drug Spending Grew at Lowest Rate in Over Four Decades

(Washington, DC)-A new report released today by researchers from the Centers for Medicare & Medicaid Services (CMS) shows a historic slowdown in drug spending growth driven largely by the increased use of generic medicines.  The Pharmaceutical Care Management Association (PCMA) believes this underscores the ability of proven pharmacy benefit management tools to lower costs while expanding access to medications.  PCMA also notes that even more savings can be generated if policymakers pursue efforts to increase physician adoption of electronic prescribing, encourage broader use of mail-service pharmacies and give the FDA the ability to approve generic alternatives to expensive biologic medicines.

“This new report underscores the value of tools pioneered by pharmacy benefit managers-including increasing the use of generic medicines-to lower costs and expand access to prescription drugs,” said PCMA President and CEO Mark Merritt.   “Pharmacy benefit managers could provide even greater savings and access if policymakers work to accelerate physician adoption of electronic prescribing, support greater use of mail-service pharmacies in federal programs, and empower the FDA to approve follow-on biologics and process applications for traditional generics in a timely manner.”

The new prescription drug data are contained in a report, “National Health Spending in 2007: Slower Drug Spending Contributes to Lowest Rate of Overall Growth Since 1998,” published in Health Affairs.   The report finds that several key factors contributed to prescription drug spending growth slowing from 8.6 percent in 2006 to just 4.9 percent in 2007, including:

• Increased generic dispensing from 63 percent of prescriptions in 2006 to 67 percent in 2007; and
• Slower overall growth in prescription drug prices and concerns about safety.

Furthermore, researchers found that per enrollee spending in the Medicare prescription drug benefit declined in 2007.  Factors contributing to the lower per enrollee spending in Part D included:

• Lower bids by Medicare plans;
• Medicare prescription drug plans’ ability to negotiate discounts and rebates from drug companies; and
• Medicare drug plans’ monitoring utilization management.

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.