A new study finds that physicians who use an e-prescribing system with formulary decision support can boost drug cost savings.
The report was funded by the Department of Health and Human Services' Agency for Healthcare Research and Quality.
According to the study, physicians can save $845,000 per 100,000 patients per year and possibly more system-wide by using a system that allows them to select lower cost or generic medications.
The study's authors believe this will have important financial implications as e-prescribing systems become more widely available and easier to use.
Complete use of an e-prescribing system with formulary decision support could reduce prescription drug spending by up to $3.9 million per 100,000 patients per year, the authors found.
Many insurers use lists of approved prescription drugs known as formularies. Under these arrangements patients are often charged the lowest co-payment for generic medications (tier 1), a higher sum for preferred brand-name drugs (tier 2) or the highest amount for non preferred brand-name drugs (tier 3).
A challenge to physicians' use of the tiered system is the lack of current data on insurers' prescription drug formularies at the time of prescribing because the information changes so frequently.
Researchers at Brigham and Women's Hospital and Massachusetts General Hospital in Boston compared the change in prescriptions written in three formulary tiers before and after an e-prescribing system was launched. The hospital's study examined data collected over 18 months from two major Massachusetts health insurers covering 1.5 million patients.
Physicians using e-prescribing with formulary decision support, which accounted for more than 200,000 filled prescriptions in the study, increased their use of generic prescriptions by 3.3 percent, the study's authors found.
Many doctors "want to do the right thing," said study author Joel Weissman, PhD, of Massachusetts General Hospital. "If they are provided information on choices of effective medicines at the point of service, they are more likely to prescribe the one that will help their patients deal with the high cost of drugs."
Based on average costs for private insurers, the study's authors estimated that using e-prescribing could save $845,000 per 100,000 patients per year and generate even higher savings with greater use.
The study's lead author, Michael A. Fischer, MD, of Brigham and Women's Hospital in Boston, noted that even physicians with e-prescribing use it only about 20 percent of the time. "Our results likely represent a conservative estimate of the potential savings," he said. "As doctors e-prescribe more frequently, the amount saved could increase dramatically."
Researchers found that physicians writing electronic prescriptions are slightly younger and more likely to be female. In addition, internists, pediatricians and family physicians make up nearly three-fourths of those who use e-prescribing. Of the 17.4 million prescriptions filled over the course of the study, about 212,000 were prescribed electronically.
"These findings show that decision support can improve value for patients," said AHRQ Director Carolyn M. Clancy, MD. "These systems have the added and important benefit of improved patient safety by flagging medication errors before they occur."