Retail Pharmacies and Pharmacy Benefits Managers Announce E-Prescription Merger

The nation's two e-prescription networks announced their merger on July 1, 2008. Competitors since 2001, when each of the companies was founded, the newly merged SureScripts-RxHub will continue to work to convert physicians and patients to an e-prescription system.

Fewer than 5 percent of prescriptions nationwide are currently submitted electronically. The biggest obstacle to moving doctors to an e-prescription setting is technology. There are no financial incentives for doctors to purchase the necessary computer systems, and the cost of the technology is significant. Legislation is currently being considered that would provide assistance to doctors purchasing e-prescription technology.

Benefits of the electronic submission of pharmaceutical prescriptions include reducing the medication error rate, often a result of handwritten errors by doctors or pharmacists who misread illegible handwriting. It is estimated that 7,000 patients die each year as a result of incorrect medication or dosages and another 1.5 million people are harmed.

Many see the successful adaptation to e-prescriptions as the first step in the eventual move to a full electronic health record. In the press release for the merger, a statement by John Driscoll, president, New Markets, Medco Health Solutions says, "Prescribing medications for patients is one of the most fundamental acts in healthcare. If we, as an industry and as a nation, are serious about improving the quality of care and making it more cost-effective, then immediate and sweeping measures are required. This merger sets aside historic economic and political differences to do what is necessary to advance paperless prescribing and the secure exchange of critical information between providers - instantly elevating the quality of care."

Primary Androgen Deprivation Therapy (PADT): Poor Treatment for Prostrate Cancer

The results of a study published in the July 9, 2008 issue of the Journal of the American Medical Association shows that the increasingly popular treatment for localized prostate cancer, PADT, actually decreases the rates of survival for most elderly men.

Prostate cancer is the most common form of cancer for men, and the second leading cause of cancer death. In treating the cancer with PADT, the idea is to block the hormone testosterone from fueling the growth of prostate cells. Because the hormone can not differentiate between healthy prostate cells and cancerous cells, it has been assumed that eliminating the growth factor will help eliminate the cancer. Other measures of treating prostate cancer typically involve surgery and/or radiation.

The results of the study, based on data collected from 19,271 males receiving medicare and diagnosed with prostate cancer between 1992 and 2002, suggest that 10-year survival rates in elderly men diagnosed with T1-T2 localized prostate cancer are not improved with PADT. This finding, along with the significant side effects and cost of the treatment, should encourage physicians to explore other treatment options for patients diagnosed with prostate cancer.

Because the study focused on men over the age of 66, the results might be different for younger men. There is not sufficient data comparing PADT with other treatment even though the rate of PADT as a treatment method has increased in recent years.

Common side effects of hormone therapy include breast enlargement, reduced sex drive, erectile dysfunction, hot flashes, weight gain and reduction in muscle and bone mass. Other studies have shown that men treated with PADT may have a slightly increased chance of heart attack in the years following treatment.

I welcome your questions, comments and feedback relating to these issue; please do so by emailing me at baileyriskmanagement@medicusins.com.