Apoteket and Medco Health Solutions develop centralized prescription safety program

Jan 7 2010

Apoteket, Sweden's largest pharmacy chain, and Medco Health Solutions, Inc. (NYSE: MHS) today announced that it has developed one of the first national centralized drug utilization review (DUR) programs outside of the United States to improve prescription safety by reducing adverse drug events and thereby reducing the risk of costly hospitalizations.

The system, called Elektroniskt ExpeditionsStod (EES), will be owned and operated by Apotekens Service AB, a national pharmacy infrastructure supplier for the Swedish health care system. The system was integrated into ten pharmacies in mid-October and will be available to all pharmacy locations throughout Sweden in early 2010. Medco partnered with Apoteket to develop the system and will have an ongoing role in supporting the national program.

Localized DUR systems are commonplace in most European pharmacies. Medco, which has one of the most sophisticated drug safety systems in the world, has adapted and reengineered its system with Apoteket to develop a leading edge system that warns pharmacists about potential safety issues within the patient's complete medication history across all pharmacies and prescribers. Medco customized the clinical safety system to incorporate drugs and clinical guidelines available in Sweden.

"Medco has developed exceptional patient safety protocols at all stages of pharmacy care and this initiative shows how we can leverage our U.S. innovations to improve patient safety and healthcare systems," said John Driscoll, Medco president for New Markets. "We shared our best practices and adapted operational capabilities to enhance Sweden's pharmacy care model, which we know will save lives."

Each time a prescription is ordered in Sweden and patient consent is obtained, it will undergo an automatic rules-driven review that examines a patient's history to identify any potential danger of the new prescription interacting with other medications or aggravating existing medical conditions. It is estimated that 30 percent of emergency care visits and 10 percent of all hospital admissions in Sweden are the result of inappropriate or unforeseen drug related interaction.

"A DUR system is crucial to identifying potential adverse drug events in health care that lead to so many hospitalizations," said Erik Thorsell, Apoteket's executive for quality assurance. "By adopting innovations and promoting collaborative pharmacy practice, we're doing our part to keep our customers safe and ensure they get the best care. The technology available is a great safety net to reduce adverse drug events, especially when patients are getting prescriptions from more than one doctor or pharmacy. This becomes more important in Sweden as we deregulate and expand the market with more choices of local pharmacies."

During the current pilot phase, the prescription drug review has led to a dialogue between the pharmacist and the patient more than one-third of the time and numerous prescriptions have either been cancelled by the prescribing physician, dosages were lowered or the original prescription was changed to a different drug.

"Medco's goal in the U.S. and abroad is to advance and improve the value of clinical pharmacy," Driscoll added.

EES enhances safety features that are provided by electronic prescribing, a proven approach to eliminating errors associated with handwritten prescriptions. Sweden leads Europe in the adoption of e-Prescribing with approximately 80 percent of all prescriptions in the country being ordered electronically by physicians.

"The Elektroniskt ExpeditionsStod will contribute substantially to diminishing unnecessary drug-related side effects, as well as help decrease drug costs," said Professor Yngve Gustafson, M.D., PhD. "Most importantly, EES will help prevent unnecessary hospitalizations due to inappropriate dosage or drug, therapy duplication, and drug-drug interactions. In addition, EES could, over time, increase the physicians' knowledge on drug treatment and consequently increase quality of care for patients, especially the elderly."

Gustafson added, "This system, once fully operational across all pharmacies in Sweden, will be of great societal benefit. In the future, it is our hope that it will also be fully integrated into our electronic prescribing systems used by physicians to aid in the decrease of prescription drug abuse."

Deregulation of Sweden's pharmacy market in July 2009 opened itself to competition from new entrants beginning in the fall of 2009. The utilization review system will become part of the common high-technology infrastructure used by all of Sweden's retail pharmacies. This would ensure comprehensive, uniform and consistent reviews of each prescription, for all patients, independent of which pharmacy is used to dispense the medicine.

Financial terms of the transaction were not disclosed and this transaction is not expected to have a material impact on Medco's earnings or results of operations. Medco's other international operations include a majority stake in Europa Apotheek, a clinical services pharmacy serving the German and Dutch markets, and Medco's joint venture in pharmacy/home health care in the United Kingdom with United Drug plc.

SOURCE Medco Health Solutions, Inc.