The article "Psychiatrist Bills Pharmacy Manager for Time" in
the November 17, 2006, Psychiatric News raises several interesting
issues by Dr. Edward Gordon that merit additional exploration.
First, assuming there is any legal basis for billing a pharmacy benefit
manager for the administrative time required to validate a
prescription—and by the way, there is none—playing out the
scenario would lead to a cascade of events that Dr. Gordon is unlikely to have
envisioned and clearly would prefer to avoid.
Last year, Medco safety alerts were triggered more than 11 million times,
warning of potential harmful drug interactions and other issues that had been
created by prescribers who, for whatever reason, wrote prescriptions that
could have potentially harmed their patients. We would ask Dr. Gordon where we
might send our invoice for building and maintaining these systems and
monitoring and correcting the prescribing errors.
Last year, Medco pharmacists were required to make more than 1.9 million
doctor contacts to clarify illegible handwriting on prescriptions. We would be
delighted to invoice prescribers to compensate our pharmacists for their lost
Last year, Medco pharmacists made an additional 1 million contacts to
suggest alternative medicines that, while providing an equivalent therapeutic
effect, would save patients and payers tens of millions of dollars.
Countless studies have shown that if physicians made greater use of
information technologies currently available, much of this frustrating
administrative work would simply disappear. Medco obviously shares Dr.
Gordon's interest in helping patients to receive the highest quality
care—but we are also committed to ensuring that care remains safe and
affordable and in conformance with federally established guidelines for
Medicare Part D.