New Analysis: More Doctors on the Care Team Correlates With Higher Risk of Adverse Drug Events in Seniors

FRANKLIN LAKES, N.J., Sept. 13 /PRNewswire-FirstCall/ — While conventional wisdom dictates that more doctors are better for your health, a new analysis released today finds that the more doctors a senior sees, the greater their risk for dangerous drug errors.

An analysis of prescription drug alerts, conducted by Medco Health Solutions, Inc. , found that the greater the number of physicians seen by a patient over age 65, the greater the number of prescriptions the patient fills, and thus the greater risk for dangerous drug errors including drug-to-drug interactions, under- or over-utilization of a drug, duplication of therapies, and incorrect dosages. The findings call into question how well different doctors and specialists caring for patients over 65 exchange information about the medications they are prescribing, and statistically correlates a larger care team with a greater risk for preventable medication errors.

According to the analysis, seniors receiving prescriptions from two different physicians filled an average of 27 prescriptions in a year, and were at risk for 10 potential prescription drug errors. However, when the care team consisted of five doctors, the number of prescriptions filled in one year nearly doubled to 42, and the number of potential drug errors increased 60 percent to 16.

When seniors received prescriptions from seven physicians the number of prescriptions increased to 52 and the number of potential drug errors more than doubled to 22 in one year, compared to those only seeing two physicians. When the care team reached 10 different physicians, patients filled an average of 66 prescriptions, and potential errors tripled.

“With more physicians providing care to patients, more prescriptions are being written — however, there is clearly a communication breakdown between prescribers,” said Dr. Glen Stettin, senior vice president, clinical and therapeutic solutions, Medco. “This analysis illustrates the potentially dangerous and unintended side effects of an expanded healthcare team — an issue that is exponentially more important now that Medicare has opened America’s medicine cabinet to many more older patients.”

The analysis reviewed the prescription drug claims between January and December 2004 of 2.4 million insured adults. The analysis identified the increased risk of drug errors associated with the number of physicians a patient sees and the number of pharmacies at which a patient fills their prescriptions — a growing trend referred to as polypharmacy. The analysis compared the potential error rates among patients 65 years of age and older with the rates of patients under age 65.

   Additional findings of the analysis include:     *  Patients over age 65 consistently experienced a drug error rate        approximately seven times greater than patients younger than 65.        Seniors faced an average of 13 potential drug errors per patient,        compared to two per patient among those younger than 65.     *  One in four seniors (24 percent) received prescriptions from five or        more doctors; one in 20 received prescriptions from eight or more        physicians.     *  Among patients 65 and older, those seeing five physicians filled        nearly twice as many prescriptions as those seeing one physician.     *  Nearly one-quarter of the seniors in the analysis filled their        prescriptions at 3 or more pharmacies, with some seniors using as        many as 11 different pharmacies for their prescriptions.     *  Among patients who see five doctors, those 65 and older fill nearly        40 percent more prescriptions than those under the age of 65.   

The implementation of Medicare Part D is expected to increase the number of seniors with prescription drug coverage and will likely increase medication utilization, potentially making this drug safety situation far worse. A recent PricewaterhouseCoopers report estimates that Medicare Part D will result in a 20 percent or more increase in prescription drug utilization by those not currently insured.

“A wider array of physicians and specialists can improve care for the patient, but it is imperative that the team — physicians, pharmacists and insurers — continually exchange information about what a senior is taking, how much of it is being prescribed, and for how long,” said Dr. Stettin.

Medco’s Polypharmacy Safety Program — Filling the Gaps in the Medication Matrix

To address the risk of the medication matrix, Medco launched its new Polypharmacy Safety Program. The new program is designed to reduce the risk of prescription drug errors by identifying patients receiving prescriptions from multiple physicians and filling prescriptions at multiple pharmacies, and providing detailed patient prescription drug history to all prescribers on the patient’s care team.

Patients in participating plans are entered into the safety program automatically by meeting criteria focusing on number of physicians, pharmacies and number and types of medications. When a patient meets all criteria, the system generates an alert report for prescribing physicians with a complete list of the patient’s current prescription drug regimen and history, and the physicians’ names and contact information that are prescribing medications to the patient.

The system was piloted in September 2005 to all Medco clients enrolled in Medco’s RationalMed(R) Patient Safety System. In a three-month period, RationalMed detected more than 4,600 patients as having a polypharmacy risk. After notifying the prescribing physicians, 50 percent of the patients realized the benefit of better coordination of care from the reduction in the number of prescribing physicians and/or the medications required to continue to treat their conditions.

“By identifying patients that are exposed to polypharmacy risks and alerting their physicians to this situation, these risks will hopefully be averted before patients suffer any harm,” said Dr. Stettin.

About Medco

Medco Health Solutions, Inc. is the nation’s leading pharmacy benefit manager based on its 2005 total net revenues of nearly $38 billion. Medco’s prescription drug benefit programs are designed to drive down the cost of pharmacy health care for private and public employers, health plans, labor unions and government agencies of all sizes, and for individuals served by the Medicare Part D Prescription Drug Program. Medco’s technologically advanced mail-order pharmacies and award-winning Internet pharmacy have been recognized for setting new industry benchmarks for pharmacy dispensing quality. Medco serves the needs of patients with complex conditions requiring sophisticated treatment through its specialty pharmacy operation, which became the nation’s largest with the 2005 acquisition of Accredo Health, Incorporated. Medco is the highest-ranked pharmacy benefit manager on the 2006 Fortune 500 list. On the Net: http://www.medco.com/.

This press release contains “forward-looking statements” as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Medco Health Solutions, Inc.

CONTACT: Jennifer Leone Luddy of Medco Health Solutions, Inc.,+1-201-269-6402, jennifer_luddy@medco.com; Bill Borden, or Melissa Mackey,both of Coyne Public Relations for Medco Health Solutions, +1-973-316-1665

Web site: http://www.medco.com/