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April 09, 2005
Purkinje Reports Dramatic Reductions in Utilization of Bextra, Vioxx and Similar Medications at Esse Health
Purkinje Reports Dramatic Reductions in Utilization of Bextra, Vioxx and Similar Medications at Esse Health
Thursday April 7, 10:16 pm ET
- Electronic prescribing system with industry-leading clinical decision support reduced prescriptions for COX-2 inhibitors by 60% well before market withdrawals
ST. LOUIS, April 7 /PRNewswire/ -- Purkinje, a leading provider of electronic medical record software with evidence-based decision support, announced that Esse Health has prescribed risky drugs such as Vioxx and Bextra at rates less than half of national averages over the past few years. Earlier today, the FDA requested that Pfizer withdraw Bextra from the market. Vioxx was withdrawn from the market on September 30, 2004.
The class of drugs called COX-2 inhibitors includes Vioxx, Bextra and Celebrex. While no more effective than ibuprofen, these newer drugs were initially thought to be safer than ibuprofen when prescribed for patients with arthritis who were also at high risk for bleeding ulcers. However, aggressive marketing resulted in these costly drugs comprising 61% of all anti- inflammatory prescriptions nationwide between 1999 and 2002.(1) Mounting evidence of adverse cardiovascular events resulted in the withdrawal of Vioxx and Bextra. Celebrex remains on the market.
Esse Health, which has used the Purkinje ePrescribing system since January of 2000, had much lower utilization rates for COX-2 inhibitors. From January of 2001 onward, only 25% of all prescriptions written for anti-inflammatory drugs at Esse were for drugs such as Bextra and Vioxx.
Esse Health was highlighted in MedStar Health's recent report on health information technology for its success in utilizing an electronic prescribing system to increase quality of care.(2) Dr. Peter Basch, Medical Director of MedStar's eHealth Initiative noted: "Most ePrescribing applications make no recommendations regarding choice between medications except to warn the physician about drug interactions, allergies, or formulary status considerations. Purkinje stands out for bringing evidence-based best practices and information on comparative efficacy to doctors at the moment of decision-making."
Esse Health played a key role in the design and development of the Purkinje electronic prescribing system, providing feedback to Purkinje's team of pharmacists and physicians who carefully study and critique the published medical literature to construct context-specific decision support messages which are delivered to busy doctors without slowing them down. Esse physicians helped to found Purkinje in 1999.
"Sometimes the FDA approves new drugs that are appropriate for a relatively small number of patients, but then direct-to-consumer advertising creates outsized demand for these new medications," said Dr. Tom Doerr, Purkinje's Chief Medical Officer. "There are often billions of dollars in revenues at stake whenever the FDA considers removing a drug from the market, resulting in tremendous pressure on the agency. Last year, a top FDA scientist and safety reviewer, Dr. David Graham, was harshly criticized when he testified that the FDA should remove 5 drugs from the market because of safety concerns. Bextra was among those medications." Dr. Doerr added, "Purkinje software gives dedicated physicians more to rely on than FDA approvals or withdrawals so that the medications they prescribe are as safe and effective as possible given the needs of individual patients."
Dr. Charles Willey, President and CEO of Esse Health noted, "Purkinje just sent us a list of all our patients with an active prescription for Bextra, along with their contact information. But more important than addressing these problems after the fact, Purkinje helps us avoid prescribing inappropriate drugs in the first place by providing specific information about the risks, benefits, costs and tradeoffs of drugs like Bextra and Vioxx, as well as alternative treatments."
Dr. Willey added, "Our group maintains medical cost ratios 15% below industry averages while outperforming our peers in quality and patient satisfaction. Last year we formed our own health plan called Essence, a Medicare+Choice health plan which offers seniors one of the most generous benefit packages in the country for the price of traditional Medicare. We rely on advanced clinical decision support in the Purkinje system to help us deliver this exceptional care to our patients."
About Purkinje
Purkinje goes beyond simply automating clinical workflow by delivering context-specific, evidence-based decision support to busy clinicians without slowing them down. Purkinje is the only electronic prescribing system proven in a peer-reviewed study to reduce outpatient medication costs. For more information, please visit http://www.purkinje.com.
About Esse Health
Esse Health is the largest independent physician group in the St. Louis area, with more than 70 physicians serving over 200,000 patients in 20 locations. Esse is 100% owned and managed by local practicing physicians. For more information on Esse Health, visit http://www.essehealth.com.
About MedStar Health
MedStar Health is a not-for-profit, community-based healthcare organization comprised of 25 integrated businesses including seven major hospitals in the Baltimore/Washington area. The MedStar e-Health Initiative (MeHI) is dedicated to educating physicians on the numerous e-strategies and e-tools available to them while helping physicians leverage e-health to improve patient care and practice management. For information please visit http://www.medstarhealth.org.
(1) Dai, Carolanne, et al. "National Trends in Cyclooxygenase-2 Inhibitor
Use Since Market Release: Nonselective Diffusion of a Selectively
Cost-effective Innovation." Archives of Internal Medicine, Publication
No. 165. January 24, 2005.
(2) MedStar Health. "At a Tipping Point: Transforming Medicine with
Health Information Technology - A Guide for Consumers." Prepared by
Leslie Harris & Associates with the support of the Verizon Foundation.
April 1, 2005.
Source: Purkinje
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