Blog | Wednesday, April 23, 2014

The medical monopoly you've never heard of


Have you had a prescription filled electronically?

The difference is no longer being handed a written prescription and having to take it to a pharmacy to be filled. E-prescribing enables the doctor to electronically send the prescription right from her computer. Fast. Clean. One stop shopping. If she picks a medication that’s a) not covered by your insurance or b) risky for a medication interaction, then the computer alerts her and she can make a different choice.

This is all possible because of Surescripts, a consortium consisting of national pharmacy chains, independent pharmacies, and the big “pharmacy benefit managers” (groups like Express Scripts or Caremark). Last year, the Surescripts network surpassed the 50% mark: half of all prescriptions are now generated electronically. It’s a big number: Surescripts reports handling 6 billion electronic transactions a year.

Imagine Coke and Pepsi uniting with artisanal/local cola makers to create a single distribution and delivery system nationwide, in which they’d share proportionally in the costs and the utilization. Seems inconceivable. Yet it’s exactly what’s happened in the retail drug industry.

Read more about it here, on NPR’s Shots blog.

One exception to e-prescribing I didn’t cover in the piece: Most states still require written prescriptions for narcotic (opioid) pain medications (think Vicodin, Lortab, Percocet, etc.) This is to add hurdles to the process for a variety of reasons. Fodder for future posts.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.