PHARMACY

E-prescribing may help compliance with new Medicaid tamper-proof rule

BY Allison Cerra

NASHVILLE, Tenn. The delay of the new tamper-resistant Medicaid prescription law may be good fortune for medical professionals, who are exercising their options.

Some providers, according to reports, have considered the idea of e-prescribing techniques to comply with the law, which requires hand-written prescriptions to be written on tamper-resistant paper.

The law is designed to cut down on Medicaid prescription fraud.

Because prescriptions submitted electronically have no risk of being altered by the patient, David Beshara, chief pharmacy officer at TennCare, says he hopes more doctors will adopt e-prescribing, if only to circumvent the new requirement.

“I think the e-prescribe channel has so many benefits that have been untapped,” Beshara said to the Nashville Business Journal. “One is fraud, the second is it really cuts down on transcription errors.”

Prescription medication errors—including adverse drug effects from combining drugs—injure 1.5 million Americans each year, according to the Institute of Medicine. Although e-prescribing is, overall, more efficient, it may not be the simplest of tasks. “Six months is not enough time for most places to adopt new technology,” Kevin Johnson, vice chairman of the department of biomedical informatics at Vanderbilt University Medical Center, told the Journal.

Johnson did say, however, that utilizing both practices might be the best problem solver and that installing dual-tray printers may help hospitals move more effectively—something Vanderbilt has already put into effect. It will allow physicians to print the prescriptions without sacrificing cost or time.

“E-prescribing is really the best solution we have,” said Johnson. “I view this particular piece of legislation as a long-term positive for e-prescribing and a short-term negative for e-prescribing.”

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PHARMACY

FDA approves supplemental NDA for Januvia

BY Allison Cerra

WASHINGTON The FDA approved a supplemental new drug application for Merck’s Type 2 diabetes drug Januvia, citing new uses and additional warnings.

The pharmaceutical company, which produces several heart-related medications, had received feedback from patients taking Januvia (sitagliptin) experiencing health problems including anaphylaxis, angioedema and undesirable skin conditions. There had been reports that patients experienced the potentially fatal skin condition known as Stevens-Johnson Syndrome.

Januvia’s revised labeling will now indicate that patients with a history of hypertension should not use the drug. The company said, however, it could not establish a causal relationship to the drug or reliably estimate the frequency of the side effects.

The updated labeling additionally states that Januvia can be used as an initial therapy or add-on therapy with other medications, including metformin and sulfonylurea.

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House Dems push through revised SCHIP, but GOP claims partisanship

BY Allison Cerra

WASHINGTON The House of Representatives approved a new version of legislation to expand the State Children’s Health Insurance Program yesterday, but the vote failed to get any more Republicans to override another promised veto from President Bush.

Democratic leaders decided the new revision would state the exclusion of illegal immigrants from the program, which would motivate state governments to drop families earning more than 300 percent of the poverty line, which will ultimately force adults off of the program.

Under both versions, the combined average monthly enrollment in SCHIP and Medicaid would be about 34.1 million people, according to the Congressional Budget Office. But there is a shift toward serving poorer children, a key Republican demand. In the new bill, Medicaid enrollment alone would be about 400,000 individuals higher than under the vetoed bill, while SCHIP enrollment would be about that much lower, according to CBO documents.

Almost half of the 3.9 million uninsured children projected to gain coverage under the revised bill, of whom about 80 percent live below the poverty level, would be covered under Medicaid, said Genevieve Kenney, an Urban Institute health economist.

According to The Washington Post, the 265 to 142 tally included 43 Republicans, two fewer than the version that passed Sept. 25.

Republicans called for a postponement of the vote due to the absence of nine members House touring the wildfire disaster in California, but Speaker Nancy Pelosi, D-Calif., insisted she had no choice but to move forward and give the Senate a chance to send the measure to Bush next week. “If Republicans believe in SCHIP as they say they do . . . then they won’t be looking for an excuse to vote against the bill,” Pelosi said.

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