An e-prescribing initiative announced recently by the Big Three automakers might help business, said Hassane Fadlallah, R.Ph. "If this is a move that could bring more prescriptions to us, that would be great," said the owner of Dix Drugstore in Dearborn, Mich., adding that nearly two-thirds of his business comes from automaker employees and their families. "It's got to be a better step for us than some of their other moves, like mandatory mail order."

The Southeast Michigan e-Prescribing Initiative (SEMI)—a collaboration of General Motors, Ford, DaimlerChrysler, and the United Auto Workers—plans to help equip 17,000 physicians with e-prescribing technology tools in the next few years. The automakers are joined in the initiative by Medco in Franklin Lakes, N.J., the pharmacy benefit manager for all three companies, and RxHub, which electronically connects payers, physicians, pharmacies, and health systems and is owned by Medco and two other PBMs. Two health plans, Blue Cross Blue Shield of Michigan and Henry Ford Health System's Health Alliance Plan (HAP), are also participating.

Greater use of e-prescribing among the physicians serving Fadlallah's customers may or may not bring in new business, said Antonio Petitta, R.Ph., HAP's VP for pharmacy care management, but it would make Fadlallah's job easier and his customers safer.

"E-prescribing increases safety as well as lowering overall costs by reducing medication errors," added John Driscoll, Medco's senior VP of product and business development. The SEMI collaborative will offer area physicians a financial incentive to offset the cost of the equipment and software they need to implement e-prescribing, he said. Each of the health plans and employers will also develop an integrated patient data infrastructure that will allow patient prescription and medical data to be checked for potential errors when a medication is prescribed, he added.

But whether SEMI actually means additional business for community pharmacists will depend on their ability to manage electronic prescriptions compared with that of their neighboring pharmacies, said Petitta. Only about half of pharmacies nationwide can do so now, according to a recent survey by SureScript Systems in Alexandria, Va., which is developing a national network connecting doctors and pharmacies and is expected to participate in the automakers' initiative.

The SEMI collaborators want to make that happen in their region as quickly as possible, said Kate Cohn-Parrott, DaimlerChrysler's director of integrated health care and disability. "We're doing this because e-prescribing improves the quality of medical care for our employees. Ultimately it might also lead to some cost savings, but that's not what we're thinking about right now," she said.

Perhaps not, but drug costs have definitely been on the Big Three's collective mind in the past couple of years. As of January 2004, the UAW agreed to a contract clause that made mail-order prescriptions mandatory for refills for drugs treating chronic conditions. "That hurt us very badly," said Gena Web, R.Ph., owner of Platinum Care Pharmacy in Detroit. "We lost most of our auto employee business then. E-prescribing isn't going to bring that back."

SEMI initially plans to recruit 6,500 doctors in Michigan to participate in its e-prescribing initiative and plans to expand to all of the region's 17,000 docs, although no timetable is set. Participation is voluntary, and the program is still working out the details about what incentives will be offered, said Medco's Driscoll.

It won't always be an easy sell, however. According to many experts, physicians have concerns about e-prescribing, including the cost, quality of technology, impact on workflow, and a concern that most of the benefits of e-prescribing come at physicians' expense. According to the Centers for Medicare & Medicaid Services, less than 10% of doctors currently prescribe electronically.