Most programs can generate return on investment of $2 or $3 for every $1 spent, Mr. "We were very happy with our return on investment," he said. Over a 38-month period, the safety alerts sent out by Medco's RationalMed tool resulted in more than 43,000 drug therapy changes and more than 4,000 avoided hospitalizations, he said.Īlthough reducing health care costs was not the company's primary motivation, AT&T saved more than $34 million during that time period because of the intervention of RationalMed, Mr. Carter said at the 2006 Employee Health Care Conference, sponsored by Towers Perrin in New York. The program has proven to be very effective in identifying potential problems and avoiding unnecessary hospitalizations within the AT&T population, Mr. "We wanted to look at something that we could do as an employer sponsoring health benefits." "Patient safety really struck a chord with us, because that's what we were trying to sponsor to make sure that (employees) were getting the appropriate care," he said. AT&T Corp., for example, decided to implement the RationalMed tool into its benefit program after a major study in 2001 highlighted various problems related to patient safety in the United States, said David Carter, benefits planning consultant for the San Antonio-based company. Gibbs would like, he said, probably because many employers are unaware of the problem caused by drug prescribing errors, he said.Įmployers that are aware of the problem have taken steps to address it. Use of these retrospective reviews-for which employers have to pay additional charges-is not as widespread as Mr. "These can be very helpful in the risk management of the patient," said Matt Gibbs, national pharmacy practice leader for Hewitt Associates Inc. The RationalMed tool falls into a category of drug safety monitoring programs known as retrospective reviews, which looks at patients over a specified time period of prescription drug usage and attempts to identify and warn of potential problems, often leading to changes in prescriptions that have been dispensed. The RationalMed alerts cover a wide range of potential problems, such as if a patient is prescribed a medication that negatively interacts with another drug or has the potential to worsen a pre-existing condition. For example, Medco has developed a tool called RationalMed, which uses a variety of data sources to identify patients at increased near-term risk for drug therapy-related hospitalizations or other adverse events and alerts physicians, pharmacists and/or patients of the potential problems. The PBMs have developed other tools that aim to prevent or intervene to reduce prescribing errors. "Whenever you can take human errors out of the process and automate where appropriate, you're going to increase the chance of getting the right drug to the right patient at the right time." Jan Berger, Chicago-based senior vp and chief clinical officer of Caremark. "That takes away (the legibility) challenge, because it's electronic," said Dr. in Whitehouse Station, N.J.ĭrug prescribing errors occur for several reasons, including the illegibility of a physician's handwriting multiple physicians treating and prescribing drugs to the same patient or patients withholding information from their doctors, either intentionally or unintentionally.Ī number of drug utilization errors can be addressed with the adoption of electronic prescribing tools that enable doctors to pick from a list of drugs and digitally send the prescription to pharmacies.Ĭaremark Inc., for example, offers its iScribe tool, which is an electronic prescribing handheld device that doctors can use to generate prescriptions for their patients. Glen Statin, senior vp-plan management products for Medco Health Solutions Inc. "I have a very strong belief that medications do very good things to keep people well, but used incorrectly or inappropriately, they have the potential to do harm," said Dr. PBMs say they were spurred to create these tools following a string of surveys in the last 10 years that showed that inappropriate use of prescription drugs was resulting in billions of dollars in unnecessary health care costs. These tools have proven to be effective in both cutting down on prescribing errors and decreasing medical costs by avoiding problematic drug interactions and unnecessary hospitalizations, observers say. Pharmacy benefit managers are developing unique tools that aim to address patient safety by detecting and reducing drug prescribing errors. Taking steps to reduce drug prescribing errors can help employers improve the health and safety of their employees while substantially reducing their health care costs.
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