SURESCRIPT, RXHUB VIE FOR FAVOR OF PHYSICIANS

MARK HAMSTRA

ALEXANDRIA, Va. -- The nation's leading pharmacy associations face an uphill battle in their efforts to create an electronic prescribing system connecting doctors and pharmacists, according to analysts.

Earlier this month, the National Association of Chain Drug Stores and the National Community Pharmacists Association, both based here, unveiled the formation of SureScript Systems, which the groups said would "provide a connection point for physician offices to efficiently reach the broadest possible number of pharmacies."

SureScript, which NACDS expects to be operational by the end of the year, is seen as retail pharmacy's answer to RxHub, St. Louis, a venture of the three largest pharmacy benefit management companies that seeks to connect doctors, pharmacists and the PBMs. Although neither RxHub nor SureScript have progressed much beyond the earliest planning stages, supermarket pharmacists have been critical of RxHub for its potential to steer patients toward the PBMs' mail-order operations and its proposal to charge pharmacies a per-transaction fee for its use.

The challenge for both ventures lies in getting physicians to adopt the idea of transmitting prescriptions electronically.

"From the doctors' perspective -- and the doctors are the key to electronic prescribing -- there's more to be gained from the PBM connectivity than there is from the pharmacist connectivity," said Elizabeth Boehm, analyst, Forrester Research, Cambridge, Mass. "It's an uphill road to get doctors to change, because you're competing with scribbling on a piece of paper, and that's very easy to do."

She said some of the advantages of electronic prescribing, such as reducing the number of call-backs from pharmacies, are not a very effective inducement for doctors because such matters are usually handled by their administrative staffs anyway.

"It's not always a clear and compelling value proposition to the doctor," she said.

Physicians have a greater need for the real-time claims adjudication that RxHub would provide, she said.

The people behind SureScript, however, said the value of having a single electronic connection to potentially the vast majority of pharmacies throughout the country could be just what the doctors ordered.

"They need pharmacies to step up and say, 'We're ready. What we would normally pick up the phone and call you with -- a question or whatever it is -- we're prepared to send it to you electronically, and we're prepared for you to respond electronically,"' said Kurt Proctor, senior vice president, pharmacy policy and operations, NACDS.

SureScript would be a nonstock membership company that would be governed by a board appointed by NACDS and NCPA equally. Proctor declined to discuss the plans for the financing of SureScript, although he said he anticipated that the company's costs to provide a system of connectivity would be minimal.

"We're not building a big infrastructure," he said. "We're not building whole new electronic systems."

He said SureScript would seek to leverage some of the technologies and standards that have already been developed by other companies for connecting pharmacies and physicians. SureScript already has been "working closely" with NDCHealth, WebMD Corp., ProxyMed, eRx Network and other pharmacy technology companies, according to NACDS.

Jim Bradley, chief executive of RxHub, said he was encouraged by the announcement.

Bradley said in previous careers he "saw the need for community pharmacy leadership" on the technology front. "It seems to me that SureScript is not a technological solution; it's a leadership solution," he said.

He also said he hoped that there would be collaboration between RxHub and SureScript.

Boehm of Forrester, however, said she doubted both ventures could co-exist.

"Technically, it's possible that the two solutions could exist in a complementary fashion, but that's not likely," she said. "PBMs have a lot of power, a lot more than community pharmacists do, and they are not likely to play favorably with SureScript."