Does e-prescribing affect market share? IMS Health says yes

Updated study probes details of the anti-cholesterol market in 2011-12

E-prescribing—rather than writing scrips that patients take to the pharmacy—is being used by the majority of physicians, according to data by SureScripts and others; the rising adoption of electronic health-record (EHR) systems is only accelerating the trend. In a perfectly rational world, one would assume that e-prescribing doesn’t affect the market share of pharma products; after all, the drug a physician prescribes shouldn’t be influenced by how the prescription is written up. But ongoing research from IMS Health shows that there are effects ranging from subtle to dramatic on this question, particularly when a generic is added into the mix of possible choices.

According to a white paper just published, a review of the anti-cholesterol market during January 2011 to December 2012 shows that e-prescribing is more pronounced among top-decile prescribers, and that while the number of prescribers going electronic increased at double-digit rates for low-decile prescribers, they were flat or slightly declining for top-decile ones. “Most high-volume prescribers have been e-prescribing for some time,” notes Chris Blenk, a senior principal in IMS Health’s Commercial Effectiveness Practice, and one of the authors of the report. “While slightly more than 50% of physicians we studied use e-prescribing, they are responsible for nearly 90% of the prescriptions filled in this category.”

Additionally, the data show that when a generic is introduced (as was the case in 2011, when Pfizer’s Lipitor [atorvastatin] went off-patent), e-prescribers switched to generics more rapidly than traditional prescribers. “Generally speaking, generics fare better in an e-prescribing environment, and branded products worse, due to stricter generic-switching policies by many payers,” says Blenk. E-prescribers chose non-atorvastatin generics 55.1% of the time, versus 52.8% for traditional prescribers, and generic atorvastatin 19.3% of the time, versus 19.0% for traditional. Further, there are signs that among branded products, some fare better with e-prescribing, and some worse. There can be a variety of reasons for this; Blenk says that pharma manufacturers generally need to be aware of how their drugs are presented in e-prescribing systems, particularly with how clinical information is presented, and how accurate payer coverage is reported.