Driscoll

"The primary goal of the collaboration is to provide an end-to-end technology platform to support the efforts of companies who participate in electronic prescribing," says John Driscoll, president of new markets for Medco and co-chairman of the newly combined entity. "The creation of a nationwide network in support of e-prescribing will provide an on-ramp to the full electronic medical record."

DR. Pezalla

SureScripts-RxHub has set a goal of processing 100 million e-prescription transactions and supports the movement of benefit information for 70 million patient visits in 2008, according to Driscoll.

Last year, there were more than 35 million electronic prescription transactions in the United States, according to Marchibroda. "Although this represents a significant increase over the previous year, it still amounts to just 2% of all the prescriptions written," she says.

Although the major health plans already are participating in SureScripts-RxHub through the legacy RxHub business, Driscoll anticipates a significant acceleration of health plan investment in this area over the next several years.

Marchibroda agrees. "Research has shown that electronic prescribing offers significant benefits in terms of patient safety, improved outcomes, and cost savings," she says. "However, the transition can be challenging. Providers need education, incentives and implementation assistance in order to be successful."

Aetna believes e-prescribing is an important innovation for reducing errors, and saves physicians' time, says Ed Pezalla, MD, MPH, national medical director for Aetna Pharmacy Management.

One Aetna study, based on 378 prescribers (physicians who have written more than 80 prescriptions) who have continued to write e-prescriptions for Aetna members, showed a 6.5% increase in formulary prescribing behavior and a 9.16% change in generic prescribing behavior.

Aetna data from March 2008 to May 2008 show that overall, 8% of Aetna's prescriptions had an alert, meaning the physician received an electronic message at the time of prescribing that showed a drug-to-drug interaction or another issue requiring attention. Of those with an alert, 16% of the prescriptions were changed by the doctor to another drug or another dose.

AN UNLIKELY PAIR?

The merger may seem unlikely because traditionally, PBMs and retail pharmacies, while close business partners, also have competed for market share.

"That will continue," Driscoll says, "but everyone will be provided a level playing field on which to compete. The board for SureScripts-RxHub also will be evenly balanced . . . and the future direction of the company will be mutually agreed upon."

The formation of SureScripts-RxHub introduces no new privacy concerns, says Driscoll. "The independently developed networks of both RxHub and SureScripts have undergone annual HIPAA assessments and . . . have been [Electronic Healthcare Network Accreditation Commission] accredited, with particular focus on privacy and security policy and business practices."