The Official Medtipster Blog

have your healthcare and afford it, too

Medicine is the best medicine; help patients keep taking it

December 07, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings Source: Boston Globe, 12.3.2010

Patients who don’t take their medications are a well-documented problem in medicine. If doctors are to spot patients who might stop complying with prescriptions, it’s vital to have a fuller understanding of why and how it happens.

As many as 40 to 60 percent of those with chronic conditions like high blood pressure, heart failure, or diabetes don’t take their medicines regularly. The reasons vary – some patients never fill their prescriptions; others feel better and stop their drug regimens; in still other cases, side effects or the burden of too many pills discourage patients from refilling their prescriptions. Whatever the motive, failing to take needed drugs leads to worse health and higher spending, as patients land in the hospital for preventable conditions that cost the health care system hundreds of millions of dollars a year.

But a new study this month in the Annals of Internal Medicine, by researchers at Brigham and Women’s Hospital and Harvard Medical School, shines the spotlight on another contributor: Patients not picking up prescriptions that have already been filled.

The analysis, funded by CVS Caremark, looked at over 10 million prescriptions filled over a 3-month span in 2008 and found that 3.3 percent were never picked up. The number seems small, but translates to 110 million abandoned prescriptions per year in the United States. It costs a pharmacy an estimated $5 to $10 to prepare, then return to the shelves, an unclaimed medication, so the authors estimate the problem could be costing more than $500 million a year. CVS Caremark has a clear interest in bringing that number down – but so do patients and doctors.

The problem could worsen as technology evolves: Prescriptions sent electronically were 65 percent more likely to be left behind, probably because they bypass the step of having the patients hand- deliver a slip to the pharmacist. As electronic prescribing continues to take hold nationwide, insurers should be vigilant that prescription fill rates may reflect compliance less accurately than with traditional prescriptions.

Not surprisingly, prescriptions with $40 to $50 copays were the most likely to be abandoned. According to William Shrank, the study’s main author, this means that during economically hard times “even insured patients are experiencing sticker shock, and walking away from the pharmacy, without filling essential medications.”

Doctors are unlikely to know their patients’ copays for drugs, but taking the time to talk about drug costs would help them identify those who might never pick up their prescriptions. Down the road, those extra minutes of chat time at the office become multiple dollars saved at the hospital bedside.

Rule OKs E-Scripts for Controlled Rx

March 25, 2010 By: Nadia Category: Medtipster, Prescription News

Medtipster Source: HDM Breaking News –¬†Joseph Goedert, March 25, 2010

The Drug Enforcement Administration in the Department of Justice has published a long-delayed interim final rule, with a comment period, to permit electronic prescriptions for controlled substances.

The rule is available at the Federal Register’s public inspection site at, and will be officially published on March 31, effective 60 days later. The DEA will accept public comments during the 60-day interval.

Controlled substances are drugs that have the potential for abuse or dependence, including opiates, stimulants, depressants, hallucinogens and anabolic steroids. These drugs account for up to 20 percent of all prescriptions, according to various studies, which has forced providers that have adopted electronic prescribing to still maintain paper processes.

The rule will permit pharmacies to receive, dispense and archive electronic prescriptions for controlled substances. The regulations, according to DEA, are an addition to, not a replacement of, existing rules governing controlled substances.

“The regulations provide pharmacies, hospitals and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the regulations will reduce paperwork for DEA registrants who dispense controlled substances and have the potential to reduce prescription forgery,” according to the interim final rule. “The regulations will also have the potential to reduce the number of prescription errors caused by illegible handwriting and misunderstood oral prescriptions. Moreover, they will help both pharmacies and hospitals to integrate prescription records into other medical records more directly, which may increase efficiency, and potentially reduce the amount of time patients spend waiting to have their prescriptions filled.”

It’s these expected benefits that industry stakeholders, and a growing number of members of Congress, have been trying to convince DEA to appreciate for nearly a decade. The agency has considered such a rule since at least May 2001 when it issued an advanced notice of proposed rulemaking on the topic. But it wasn’t until four years later than the DEA began to examine how to revise its rules to permit electronic prescriptions.

In December 2007, a 50-member coalition of stakeholders sent President Bush a letter asking for movement on the issue. “The country can no longer afford to have a two-tiered prescribing system,” the letter stated. Nineteen U.S. Senators soon followed with their own letter. The agency finally published a proposed rule in June 2008, and 11 senators sent another letter in May 2009 asking for the final rule.

Get Adobe Flash playerPlugin by wordpress themes