The Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) has just released information regarding a study funded by the AHRQ, demonstrating that electronic prescribing (e-prescribing) systems allowing physicians to select lower cost or generic medications can save over $800,000 per 100,000 patients per year. The study, entitled "Effect of Electronic Prescribing with Formulary Decision Support on Medication Use and Cost," is published in the December 8 issue of the Archives of Internal Medicine. The study examined the data collected over 18 months from two major Massachusetts health insurers covering 1.5 million patients.

According to the AHRQ's press release, the study suggests that use of e-prescribing is likely to rise as it becomes widely available and easier to use. The potential of e-prescribing is important, the Agency says, when insurers, policymakers, and patients are trying to control the price of drugs.

The Agency's release says that to contain costs, 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) and the highest amount for non preferred brand-name drugs (tier 3)."
A problem with the system is a lack of current data on the insurers' prescription drug formularies at the time of prescribing, as the information often changes. The researchers in the study tested the cost-savings potential of an e-prescribing system that included data on insurers' formularies. The researchers compared the change in prescriptions written in three formulary tiers before and after an e-prescribing system was initiated.

The results showed that doctors using e-prescribing with formulary decision support (accounting for more than 200,000 filled prescriptions in the study) increased the use of generic prescriptions by 3.3 percent. The study reports that those changes "were above and beyond increasing use of generics that was occurring among all doctors and the already high rate of generic drug use in Massachusetts."

The researchers found that doctors who wrote electronic prescriptions were slightly younger and more likely to be female than those who did not utilize e-prescribing. Nearly three-quarters of those who used e-prescribing were Internists, pediatricians, and family physicians.

The Agency's release also states that "Using e-prescribing systems has the potential to improve drug safety by avoiding drug-drug interactions, drug-disease interactions and other potential drug safety issues."

Adapted by a press release from the AHRQ.

Archives of Internal Medicine:
(Arch Intern Med. 2008;168[22]:2433-2439.)

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