Staffing up, RxHub seeks support to boost e-prescribing


Three PBM executives give details on RxHub



Staffing up, RxHub seeks support to boost e-prescribing

Pharmacists may have concerns about RxHub—the infrastructure three pharmacy benefit managers are creating to facilitate e-prescribing—but the new venture is pressing ahead. In fact, there's a huge probability that a new CEO will be selected from a short list of three candidates in the next six weeks. Also, interviews for a CIO will begin shortly.

Representatives from the three PBMs—AdvancePCS, Express Scripts, and Merck-Medco—gave an update on RxHub (Drug Topics, March 19) at the Academy of Managed Care Pharmacy annual meeting in Tampa last month.

According to Donna Whiteford, v.p. of marketing to the physician audience at Merck-Medco, the three companies thought the hard part was getting together, since they compete so fiercely in the marketplace. In fact, "now the real work begins," she told the audience. Each firm has devoted at least two people to work on technology. This includes four components: patient identification, route to Rx fulfillment, systems integration, and interface specifications. Specifications are being developed for each component, and requests for proposals will be issued soon. Based on the responses received, the teams will then decide whether to build or buy for each of these components. Another piece the joint venture is working on is setting up the business system, such as accounting, the help desk, call center, and so on.

It will be up to the new managers to decide what the transaction fees will be for RxHub's subscribers, which include participating PBMs, point-of-care (POC) vendors, and pharmacies, Whiteford continued. Physicians will participate but will not be asked to bear any cost. At this point, the fees to subscribers are not available yet. She stressed that, as a nonprofit organization, RxHub is not designed to make a profit.

Backing her up is Agnès Rey-Giraud, v.p. and general manager of Express Scripts' e-business division. She said that once the three founders recover their capital over the next five years, fees will go down for everyone who uses this open utility. She encouraged all PBMs, POC vendors, and pharmacies to join this network, which will link physicians to their patients' pharmacies and PBMs. Other PBMs that participate must sign a letter of intent. The more parties that take part, she said, the more quickly physicians will adopt e-prescribing.

Where possible, RxHub will use existing technology standards, rather than set up new ones, said Jeff Jackson, v.p. of e-business product development for AdvancePCS. In fact, the National Council for Prescription Drug Programs (NCPDP) provides most of what RxHub needs already, he noted. However, there are still some areas where standards are needed, which the teams are discovering as they prepare their interface and unique identifier specifications, he added.

There have been other consortiums similar to RxHub that have fizzled in the past, Jackson acknowledged. But RxHub is different because the founders have jointly invested $60 million in this enterprise. Another strength of RxHub is that, among the three PBMs, they cover 150 million lives and one billion Rxs a year—enough scale to command attention, he pointed out.

While the three PBM executives didn't specify how much the transaction fees will be in their remarks, another speaker in a separate session on e-prescribing threw some numbers on the table (see box). Mark Zitter, M.B.A., chairman of The Zitter Group, a consulting firm in Oakland, Calif., said that, based on research he has done with analysts, he believes many parties would be willing to pay for e-prescribing. Besides PBMs, vendors, and pharmacies, Zitter thinks physicians, pharmaceutical companies, and hospitals would be willing to pay for this service. E-prescribing will yield enough efficiencies to stakeholders that there will be enough dollars to pay for it, he maintained.

Judy Chi


Parties involved
How much/For what

$0.65-$1.50/electronic plan-verified script
$0.25/clean script
Drug companies
$800-$3,000/sponsored doctor/year
$2-$3/electronic appointment


Judy Chi. Staffing up, RxHub seeks support to boost e-prescribing. Drug Topics 2001;9:21.

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